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Abstract #9987 Published in IGR 5-3
Assessment of nonpenetrating deep sclerectomy with reticulated hyaluronic acid implant SKGEL and/or preoperative application of 5-luorouracil: results of two and a half years
Detry Morel M; De Temmerman SBulletin de la Société Belge d'Ophtalmologie 2003; 287: 53-62
PURPOSE: To assess the effectiveness and safety of deep sclerectomy (DS) with reticulated hyaluronic acid implant (SKGEL) and/or 5-fluorouracile (5-FU). MATERIAL-METHODS: Forty-two phakic eyes (42 patients) (mean age: 61.0 ± 11.5 years) with medically uncontrolled open angle glaucoma and without a history of previous filtering procedure were included in this non-randomized retrospective study. According to the peroperative protocol, the patients were categorized into three groups: DS + SKGEL (seven eyes), DS + 5-FU (50/mg/ml for three minutes; 13 eyes) and group C with SKGEL and 5-FU simultaneously (22 eyes). RESULTS: Mean follow-up was 30.6 ± 9.2 months and was significantly shorter in group C. The three groups were comparable with respect to age of the patients, severity of glaucomatous defects, distribution of the target IOP, mean number and duration of preoperative medications, as well as mean preoperative visual acuity and intraocular pressure (IOP). Mean IOP was significantly decreased from 27.3 ± 3.2 to 16.1 ± 3.7 mmHg (p < 0.0001) and was not significantly different between the three groups at 24 months' follow-up (p > 0.05). Mean visual acuity was not significantly altered in the three groups (p > 0.05). Complete (target IOP reached without medication or YAG laser goniopuncture) and qualified (target IOP reached with medication and/or YAG laser goniopuncture) final success rates were 33.3% and 83.3%, respectively. The frequency of distribution of success was not significantly different between the three groups, but the percentage of success was 100% in group A, 84.6% in group B and 77.2% in group C. Subconjunctival injections were needed in 33% in the first postoperative month. (group A: 28.5%; group B: 46.2%; group C: 27.2%) (X2 p > 0.05). Postoperative complications were relatively minor and were observed in 66% (p > 0.05 between the three groups). YAG laser goniopunctures were performed in 38% (group A: 16.6%; group B: 61.5%; group: 33.3%, X2 p > 0.05). Complete and qualified success probability was better in the SKGEL group compared to the other two groups. CONCLUSIONS: Considering its limitations and with a follow-up of two and a half years, this study confirmed the safety and efficacy of DS in return for which topical medication(s) and/or YAG laser gonioperforations were needed in a relatively high percentage of the cases. The benefits of the SKGEL implant on the quality of IOP control appeared to be higher than 5-FU. LA: French
Dr. M. Morel Detry, Cliniques Universitaires St Luc, UCL, Brussels, Belgium. detry@ofta.ucl.ac.be
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
