Preliminary evaluation of nonpenetrating deep sclerectomy with autologous scleral implant in open-angle glaucoma.
OBJECTIVE
The aim of this study is to evaluate the short-term result of the use of an autologous scleral implant during the nonpenetrating deep sclerectomy operation instead of the more expensive collagen implant.


METHODS
Prospective nonrandomized pilot study.


METHODS
This study included 20 eyes of 20 patients with a mean age of 42.3+/-8.1 years and the mean of preoperative best-corrected visual acuity was 0.66+/-6.2. All patients were indicated for conventional deep sclerectomy operation but with implantation of an autologous scleral implant. The operation was considered completely successful if the intraocular pressure (IOP) is below 18 mmHg without medications while qualified success was considered if the IOP was below 18 mmHg with medications.


RESULTS
This technique succeeded in declining the mean IOP from 33.1+/-6.2 mmHg preoperatively to 14.6+/-3.8 mmHg postoperatively by the end of the follow-up period (12 months). Complete and qualified successful results were seen in 85% of cases. Nd:YAG goniopuncture was needed in 45% of the cases. This intervention was needed 14.0+/-10.0 weeks postoperatively. The study group showed low incidence of postoperative complication with statistically nonsignificant effect on the postoperative visual acuity.


CONCLUSIONS
The use of autologous scleral implant can be of value in controlling the IOP with low cost to the patient. Nd:YAG goniopuncture is to be performed around the third month postoperatively in cases with advanced glaucomatous changes to avoid the problem of early implant induced fibrosis. Further long-term comparative study on wider scale is needed to detect the exact value of this technique and to evaluate its long-term result.
Mousa
A S G
AS
Department of Ophthalmology, Faculty of Medicine, Ain Shames University, Cairo, Egypt. amr_s_mousa@yahoo.com
D000328:Adult; D005260:Female; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012086:Reoperation / Q000379:methods; D012590:Sclera / Q000637:transplantation*; D012599:Sclerostomy / Q000295:instrumentation* / Q000379:methods; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity