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Abstract #27487 Published in IGR 12-4
Results of a modified non-penetrating deep sclerectomy in the treatment of open angle glaucoma with or without cataract
Kitsos G; Aspiotis M; Alamanos Y; Psilas KClinical Ophthalmology 2010; 4: 695-701
Purpose: To present the technique of a modified deep sclerectomy, which we will call "reversed" deep sclerectomy (RDS) and the results and our observations of its use in patients with open ngle glaucoma (OAG) and with or without cataract extraction (phacoemulsification). Materials and methods: This prospective study included 132 eyes which underwent RDS: 37 eyes (group A) with uncontrolled OAG and 95 eyes (group B) with OAG and visually significant cataract. Mean pressure preoperatively for group A was 24.48 (plus or minus) 4.92 mmHg and for group B was 22.99 (plus or minus) 3.00. The mean number of antiglaucoma drugs received was 2.97 (plus or minus) 0.69 and 2.56 (plus or minus) 0.73 for groups A and B respectively. The RDS was performed where the deep scleral stroma is prepared in 2 parts, folded and inserted under the lateral sides of the sclerectomy, and the Schlemm's canal is opened prior to deep scleral stroma preparation. Cataract was extracted by phacoemulsification through the same scleral opening. The follow-up for group A was 22.23 (plus or minus) 10.18 months and for group B, 25.36 (plus or minus) 10.12 months. Results: Postoperative intraocular pressure (IOP) (less-than or equal to) 21 mmHg was achieved for group A in 40.5% without antiglaucoma drugs and 94.6% with antiglaucoma drugs, and for group B in 66.3% and in 94.7% respectively. Mean IOP reduction was 7.02 (plus or minus) 6.35 mmHg (28.67%, P, 0.05) for group A and 5.26 (plus or minus) 3.72 mmHg (25.06%, P (less-than or equal to) 0.05) for group B, while mean drug reduction was 1.97 (plus or minus) 1.09 (P< 0.01) and 2.14 (plus or minus) 0.95 (P (less-than or equal to) 0.01) respectively. 5-Fluorouracil was used in 8 eyes of group A and in 5 eyes of group B. Conclusion: In the follow-up time during which the two groups were under study, the RDS was effective with a few complications, similar to the classic deep sclerectomy using mplants or not, with the advantage, in our opinion, of a short learning curve. (copyright) 2010 Kitsos et al, publisher and licensee Dove Medical Press Ltd.
G. Kitsos. Department of Ophthalmology, Medical School, University of Ioannina, 45110, Ioannina, Greece. gkitsos@cc.uoi.gr
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
