advertisement
Abstract #15579 Published in IGR 1-3
Non-penetrating deep sclerectomy: preliminary results
Bas JM; Goethals MJBulletin de la Société Belge d'Ophtalmologie 1999; 272: 55-59
PURPOSE: To study the short-term efficiency and safety of a new filtering procedure, the non-penetrating deep sclerectomy, in the treatment of open-angle glaucoma. METHODS: The authors conducted a retrospective study (January 1998-September 1998). Their material included a consecutive non-randomized series of 29 patients, 34 eyes in total. The mean age was 68 years. The mean follow-up period was 5.3 months (3-8 months). Preoperatively, all eyes suffered from medically uncontrolled glaucoma. Under a fornix-based conjunctival flap, through deep sclerectomy, the external wall of Schlemms canal is removed. Ultimately, only the trabeculodescemetic membrane remains intact. At this moment, visible filtration of the aqueous humor is obtained through this thin trabeculo-descemetic membrane, which is responsible for the IOP-lowering mechanism of the deep sclerectomy. Peroperative and postoperative complications were noted. Visual acuity, slit-lamp examination and intraocular pressures were noted preoperatively and at Days 1, 2, 7 and each month after surgery. RESULTS: During the learning period, (micro)perforation of the anterior chamber occurred in nine eyes (perfDS group). In the remaining 25 eyes (nonperfDS group) two IOP failures were noted (IOP >20 mmHg). In the nonperfDS group, the mean IOP decreased from 5.64-7.28 mmHg preoperatively to 15.31-4.28 mmHg at the end of the follow-up. Postoperative complications were rare and transient. CONCLUSIONS: Non-penetrating deep sclerectomy seems to be an efficient procedure in the treatment of open-angle glaucoma. It is a difficult technique to learn and, during the learning period, perforation of the anterior chamber is the main complication. It allows a progressive decrease in IOP and thus a very low rate of associated complications.
Dr. J.M. Bas, Department of Ophthalmology, Catholic University of Leuven, Leuven; Belgium
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)