Non-penetrating deep sclerectomy without or with autologous scleral implant in open-angle glaucoma: medium-term results.
BACKGROUND
This study compares the medium-term success rate and complications of non-penetrating deep sclerectomy (NPDS) without and with autologous scleral implant in open-angle glaucoma.


METHODS
Retrospective review of 93 eyes of 93 patients with medically uncontrolled open-angle glaucoma who underwent NPDS without (n=69, group 1) or with (n=24, group 2) autologous scleral implant.


RESULTS
The mean follow-up was 16 months (range 5-36) in group 1 and 15 months (range 4-28) in group 2. The mean intra-ocular pressures (IOP) pre- and postoperatively were, respectively, 23.8 and 16.1 mmHg in group 1, and 25.6 and 15.8 mmHg in group 2. The absolute success rate was 41% in group 1 and 54% in group 2. The qualitative success rate was 83% in group 1 and 75% in group 2. An IOP lower than 16 mmHg was obtained in 51% of patients in group 1 and 58% of patients in group 2. A Nd:YAG laser goniopuncture was performed in 30% of patients in group 1 and 50% of patients in group 2, and resulted in a better controlled IOP.


CONCLUSIONS
NPDS without or with an autologous scleral implant is a safe procedure reducing the IOP significantly, but probably not sufficient when an IOP below 16 mmHg is required. We found no statistically significant difference between the two groups.
Devloo
Sylvie
S
Department of Ophthalmology, Middelheim Hospital, Antwerp, Belgium. sylviedevloo@yahoo.com
Deghislage
Cathérine
C
Van Malderen
Lidwine
L
Goethals
Marc
M
Zeyen
Thierry
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012590:Sclera / Q000637:transplantation*; D012599:Sclerostomy / Q000379:methods*; D013536:Suture Techniques; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014792:Visual Acuity