Post-operative inflammation following deep sclerectomy with collagen implant versus standard trabeculectomy.
BACKGROUND
An investigation was carried out to compare post-operative inflammation following deep sclerectomy with collagen implant (DSCI) versus standard trabeculectomy.


METHODS
In this prospective randomized study, 46 eyes of 46 Caucasian patients with medically uncontrolled chronic open-angle glaucoma and without previous glaucoma surgery underwent filtering surgery. Twenty-four eyes underwent DSCI. Twenty-two eyes underwent standard trabeculectomy. Pre- and post-operative flare, measured using laser flare photometry, were compared between the two groups.


RESULTS
In both groups, the mean anterior chamber flare increased on the first post-operative day, then decreased progressively. DSCI was associated with lower flare measurements post-operatively. The difference was statistically significant up to 1 month post-operatively: 16.3 +/- 7.8 vs 72.5 +/- 38.9 (P < 0.001) at 1 day, 7.8 +/- 4.6 vs 44.7 +/- 29.2 (P < 0.001) at 1 week, 5.9 +/- 1.6 vs 7.0 +/- 2.8 (P = 0.012) at 1 month, 6.4 +/- 1.8 vs 6.5 +/- 1.9 (P = 0.77) at 2 months, 5.9 +/- 1.8 vs 6.1 +/- 1.6 (P = 0.65) at 3 months.


CONCLUSIONS
Surgically induced inflammation can be reduced with DSCI. This may be due to the lack of iridectomy, irrigation, and penetration of the anterior chamber. Eyes at increased risk of post-operative inflammation, such as those with uveitic or traumatic glaucoma, may benefit from this procedure. Further studies are needed to evaluate the long-term functional and anatomical outcomes of DSCI.
LSU Eye Center, New Orleans, LA 70112-2234, USA.
A G
AG
Chiou
A
A
Mermoud
D A
DA
Jewelewicz
D000368:Aged; D002908:Chronic Disease; D003094:Collagen; D005260:Female; D015590:Fluorophotometry; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D011446:Prospective Studies; D019736:Prostheses and Implants; D012599:Sclerostomy / Q000009:adverse effects* / Q000379:methods; D014130:Trabeculectomy / Q000009:adverse effects* / Q000379:methods; D014606:Uveitis, Anterior / Q000209:etiology* / Q000517:prevention & control
D003094:Collagen