A comparison of the efficacy of Holmium laser sclerostomy ab externo versus trabeculectomy in the treatment of glaucoma.
We compared 15 patients who had undergone Holmium laser sclerostomy ab externo with 15 who had had trabeculectomy. In the short term, laser sclerostomy led to adequate control of intraocular pressure, but in the longer term it compared unfavourably with trabeculectomy in terms of efficacy, complications and reoperation rate. At 1 year follow-up, 8 patients in the laser group had had to undergo a second operation compared with none in the control trabeculectomy group, and 7 were still on glaucoma medication compared with 2 in the control group. Iris prolapse into the internal sclerostomy ostium within 2 months accounted for most failures, and was only partially amenable to Nd:YAG peripheral iridectomy. This common complication seems to be related to anterior chamber depth. There also appears to be a tendency for blockage of the sclerostomy with cellular or fibrinous debris. Recent literature is reviewed and modifying strategies discussed.
Ah-Fat
F G
FG
Southampton Eye Unit, Southampton General Hospital, UK.
Canning
C R
CR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007499:Iris Diseases / Q000150:complications; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011391:Prolapse; D012086:Reoperation; D012599:Sclerostomy / Q000379:methods; D013997:Time Factors; D014130:Trabeculectomy; D016896:Treatment Outcome