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Abstract #10032 Published in IGR 5-3
Treatment of open angle glaucoma with deep sclerectomy combined with laser trabecular puncture
Yin J; Tong F; Wu L; Wu RChinese Journal of Ophthalmology 2003; 39: 466-470
OBJECTIVE: To study the effect of deep sclerectomy combined with laser trabecular puncture for the treatment of open angle glaucoma (OAG). METHODS: Deep sclerectomy was performed in 32 eyes of 32 patients with moderate to advanced stages of OAG. After exposure of the external wall of Schlemm's canal and the remaining trabecula, the intraocular optic fiber of a diode laser photocoagulator was directed towards the trabecular limbus near the anterior edge of the scleral spur. Two or three punctures, approximately 0.5 mm in diameter, were performed with the leaser beam under direct visualization until aqueous humor was extravasated slowly. The scleral flap was closed with one or two sutures. Postoperative observation included intraocular pressure (IOP), intraocular tissue reaction, appearance of a filtering bleb, gonioscopy, and ultrasound biomicroscopy. The follow-up period was four to 24 (7.94 ± 6.20) months. RESULTS: The anterior chamber recovered shortly after the operation and visual acuity remained the same in all eyes. At the end of the follow-up period, postoperative IOP (14.86 ± 4.15 mmHg) was lower than preoperatively (29.68 ± 5.76 mmHg). The difference was statistically significant (t = 7.415; p < 0.001). Diffuse and obvious filtering blebs were found in all eyes after the operation, including 27 functional blebs and five that disappeared two to three months later. The iris was burned slightly in two cases, pigment was released and temporarily appeared in the anterior chamber. No laser injury occurred in the cornea or lens. CONCLUSIONS: Deep sclerectomy with laser trabecular puncture can effectively reduce IOP, without the occurrence of the serious complications that are commonly seen after trabeculectomy. This is an effective surgical method for the treatment of OAG. LA: Chinese
Dr. J. Yin, Department of Ophthalmology, Affiliated Second Hospital, Medical College of Zhejiang University, Hangzhou 310009, China. xlren@zju.edu.cn
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)