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1 General aspects (0)   1.1 Epidemiology (2)   1.2 Population genetics (5)   1.3 Pathogenesis (5)   1.4 Quality of life (2)   1.5 Glaucomas as cause of blindness (3)   1.6 Prevention and screening (3) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (2)   2.2 Cornea (6)   2.3 Sclera (1)   2.4 Anterior chamber angle (0)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (7)     2.5.2 Schlemms canal (1)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (1)     2.6.1 Production (1)     2.6.2 Outflow (3)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (9)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (1)   2.9 Ciliary body (2)   2.10 Lens (1)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (3)   2.13 Retina and retinal nerve fibre layer (21)   2.14 Optic disc (17)   2.15 Optic nerve (3)   2.16 Chiasma and retrochiasmal central nervous system (0)   2.17 Stem cells (0)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (0)   3.2 Electron microscopy (1)   3.3 Immunohistochemistry (14)   3.4 Molecular genetics (4)     3.4.1 Linkage studies (15)     3.4.2 Gene studies (1)   3.5 Molecular biology incl. SiRNA (4)   3.6 Cellular biology (2)   3.7 Biochemistry (1)   3.8 Pharmacology (0)   3.9 Pathophysiology (2)   3.10 Immunobiology (0)   3.11 Pharmacogenetics (0)   3.12 Proteomics (0)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (0)     3.13.4 Other (0)   3.20 Other (1) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (19)   5.1 Rodent (0)   5.2 Primates (0)   5.3 Other (0) 6 Clinical examination methods (2)   6.1 Intraocular pressure measurement; factors affecting IOP (22)     6.1.1 Devices, techniques (0)     6.1.2 Fluctuation, circadian rhythms (0)     6.1.3 Factors affecting IOP (0)   6.2 Tonography, aqueous flow measurement (see also 2.6) (0)   6.3 Biomicroscopy (slitlamp) (1)     6.3.1 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Refractive errors in relation to glaucoma (1)   8.1 Myopia (1)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (0) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (1)     9.1.1 Congenital glaucoma, Buphthalmos (2)     9.1.2 Juvenile glaucoma (0)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (3)     9.1.4 Other (1)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (1)     9.2.2 Other risk factors for glaucoma (7)     9.2.3 Open angle glaucoma with elevated IOP (0)     9.2.4 Normal pressure glaucoma (6)   9.3 Primary angle closure glaucomas (5)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (3)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (2)     9.3.3 Plateau iris syndrome (0)     9.3.4 Primary angle closure suspect (0)     9.3.5 Primary angle closure (0)     9.3.10 Other (3)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (3)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (0)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (0)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (1)       9.4.4.1 Exfoliation syndrome (8)       9.4.4.2 Glaucomas associated with cataracts (2)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (1)       9.4.5.1 Neovascular glaucoma (3)       9.4.5.5 Other (0)     9.4.6 Glaucomas associated with inflammation, uveitis (3)     9.4.7 Glaucomas associated with ocular trauma (0)     9.4.8 Glaucomas associated with intraocular tumors (0)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (0)       9.4.11.2 Glaucomas in aphakia and pseudophakia (1)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (0)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (1)     9.4.15 Glaucoma in relation to systemic disease (12)     9.4.20 Other (1) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (7) 11 Medical treatment (0)   11.1 General management, indication (10)   11.2 Cholinergic drugs (0)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (8)     11.3.4 Betablocker (14)     11.3.5 Other (0)   11.4 Prostaglandins (23)   11.5 Carbonic anhydrase inhibitors (0)     11.5.1 Systemic (0)     11.5.2 Topical (11)   11.6 Osmotic treatment (1)   11.7 Treatment of bloodflow (3)   11.8 Neuroprotection (14)   11.9 Gene therapy (0)   11.13 Combination therapy (0)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (0)     11.13.3 Betablocker and brimonidine (0)     11.13.4 Betablocker and prostaglandin (0)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (7)   11.15 Other drugs in relation to glaucoma (1)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (6)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (0)   11.20 Other (6) 12 Surgical treatment (0)   12.1 General management, indication (7)   12.2 Laser iridotomy (0)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (3)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (0)     12.8.1 Without tube implant (4)     12.8.2 With tube implant or other drainage devices (7)     12.8.3 Non-perforating (12)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (13)     12.8.11 Complications, endophthalmitis (8)   12.9 Trabeculotomy, goniotomy (0)   12.10 Cyclodestruction (5)   12.11 Cyclodialysis (3)   12.12 Cataract extraction (1)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (2)   12.14 Combined cataract extraction and glaucoma surgery (3)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (5)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (2)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (0) 15 Miscellaneous (1)

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Abstract #10229 Published in IGR 6-1

Comparative study between deep sclerectomy with and without collagen implant: long-term follow-up

Shaarawy T; Nguyen C; Schnyder C; Mermoud A
British Journal of Ophthalmology 2004; 88: 95-98

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AIM: To identify the value of using collagen implant in deep sclerectomy. METHODS: A prospective randomized trial of 104 eyes (104 patients) with medically uncontrolled primary and secondary open angle glaucoma. All patients had deep sclerectomy (DS), half of them with and the other half without a collagen implant (CI) sutured in the scleral bed. The main outcome measures were intraocular pressure (IOP), visual acuity, number of treatments preoperative and postoperative, and Nd:YAG goniopunctures. RESULTS: Mean follow-up period was 44.5 (SD 21) months for the DS group and 43.9 (SD 14) months for the deep sclerectomy with a collagen implant (DSCI) group. The mean preoperative IOP was 23.3 (SD 7.2) mmHg for the DS group and 25.6 (SD 4.9) mmHg for the DSCI group. The mean IOP at the first postoperative day was 6.1 (SD 4.21) mmHg for the DS group and 5.1 (SD 3.3) mmHg for the DSCI group. At 48 months, IOP was reduced by 40% (14 versus 23.3 mmHg) for the DS group and by 50% (12.7 versus 25.6 mmHg) for the DSCI group. Complete success rate, defined as IOP lower than 21 mmHg without medication, was 34.6% (18/52 patients) at 48 months for the DS group, and 63.4% (33/52 patients) for the DSCI group. Qualified success rate; patients who achieved IOP below 21 mmHg with or without medication, was 78.8% (41/52 patients) at 48 months and 94% (49/52 patients) for the DSCI group. The mean number of medications was reduced from 2.1 (SD 0.8) to 1.0 (SD 1) after DS, and was reduced from 2.2 (SD 0.7) to 0.4 (SD 0.6) in the DSCI group (p = 0.001) CONCLUSIONS: The use of a collagen implant in DS enhances the success rates and lowers the need for postoperative medication.

Dr. T. Shaarawy, Department of Ophthalmology, Hopital Ophtalmique Jules Gonin, University of Lausanne, Avenue de France 15, CH-1004 Lausanne, Switzerland. Shaarawy@glaucoma-surgery.com

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Classification:

12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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