Abstract (IGR: 3-2) | International Glaucoma Review #

Abstract #6549 Published in IGR 3-2

The clinical effect of non-penetrating trabecular surgery with reticulated sodium hyaluronate implant for treatment of primary open-angle glaucoma

Ye T; Zhang X; Yu M
Chinese Journal of Ophthalmology 2001; 37: 273

OBJECTIVE: To evaluate the clinical effect of non-penetrating trabecular surgery (NPTS) with reticulated sodium hyaluronate implant in primary open-angle glaucoma (POAG). METHODS: NPTS with reticulated sodium hyaluronate implant was performed on 27 eyes of 25 patients with POAG. The procedure consisted of excising deep scleral tissue, including the external wall of Schlemm's canal under a scleral flap without opening the anterior chamber, as the inner wall of the canal was left in place. Then a 3.0 x 4.5 x 0.5 mm or 3.5 x 3.5 x 3.5 mm reticulated sodium hyaluronate implant was placed under the flap, so that the aqueous humor could filter through the thin layer of trabeculocorneal membrane spontaneously, without forming a flat chamber. The postoperative intraocular pressure (IOP), inflammation and filtering bleb were analyzed. All the patients underwent ultrasound biomicroscopy (UBM) and gonioscopy to evaluate the surgical site at postoperative weeks 2, 3 and 6, and at nine months. The mean follow-up was 6.61 ± 2.47 months. RESULTS: IOP decreased from a mean preoperative value of 26.36 ± 9.02 mmHg (1 mmHg = 0.133 kPa) to a mean postoperative value of 14.18 ± 3.51 mmHg (t = 6.875, p < 0.05). The number of antiglaucomatous medications, topical or systemical, was reduced from 2.96 ± 1.43 sorts preoperatively to 0.77 ± 1.07 sorts postoperatively. Visual acuity remained stable (no statistical difference on the Χ test). Six eyes had elevated IOP after the operation, and were controlled by eye drops or trabecular puncture with an Nd:YAG laser. slight hyphema occurred in four eyes with small punctures during the operation. Complications such as flat chamber, inflammation and choroidal detachment were not encountered. UBM showed that the sodium hyaluronate implant degraded and a transparent liquid space existed under the scleral flat in all patients at three months postoperatively. Gonioscopy showed that, at the surgical site, a thinner and semitransparent trabecular membrane and changes in the transparent cavity could be seen in 23 eyes. In the other eyes, the trabecula was translucent at the site. Filtering blebs were formed in eight eyes. CONCLUSIONS: Non-penetrating trabecular surgery with a reticulated sodium hyaluronate implant can effectively lower IOP and reduce the number of antiglaucomatous medications. Visual acuity can remain unchanged, and no serious complications, like those seen in tradition trabeculectomy, occur. This is a new, simple and effective procedure for the treatment of POAG. LA: Chinese

Dr T. Ye, Zhongshan Ophthalmic Center, Syn Yat-sen University of Medical Sciences., Guangzhou 510060, China

Classification:

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

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