title: Deep Sclerectomy With a New Nonabsorbable Uveoscleral Implant (Esnoper-Clip): 1-Year Outcomes.
abstract: OBJECTIVE
  To report the safety and the effectiveness of deep sclerectomy (DS) with a new nonabsorbable uveoscleral hema implant (Esnoper-Clip) designed to increase trabecular and uveoscleral outflow and to achieve higher intrascleral blebs.
  
  
  METHODS
  Twenty-seven eyes of 27 patients with open-angle glaucoma, who underwent DS with an Esnoper-Clip implant, were included in this study. All patients were followed up after 12 months.
  
  
  RESULTS
  A significant decrease in intraocular pressure was observed after surgery, changing from a preoperative mean of 26.6±5.2 mm Hg to a postoperative mean of 15.3±5 mm Hg (P<0.001) at 12 months. There was also a significant reduction in the number of glaucoma drugs needed, varying from 2.5 per patient to 0.3 (P<0.001) 1 year after surgery. The main intrascleral lake height and volume at 12 months was 0.7±0.1 mm and 3.9±1.3 mm, respectively. No intraoperative complications occurred. The main postoperative complications were a positive Seidel test result at 24 hours in 2 eyes (7.4%), hyphema in 2 eyes (7.4%), and choroidal detachment in 1 eye (3.7%). All these complications resolved successfully. The need for additional mitomycin-C injections was recorded in 4 eyes (14.8%), twice in 2 of them. Twelve eyes (44.4%) underwent postsurgical Nd:YAG laser goniopuncture with a mean time between surgery and this procedure of 4.3 months. Mean intraocular pressure after Nd:YAG laser goniopuncture decreased from 19.2 to 15.5 mm Hg (P<0.001).
  
  
  CONCLUSIONS
  DS with an uveoscleral hema implant (Esnoper-Clip) is a safe and effective technique for the management of open-angle glaucoma.
authors.affiliation: Department of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Servicio de Oftalmología, Universitat Autonoma Barcelona, Badalona, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Loscos-Arenas
authors.forename: Angels
authors.initials: A
authors.lastname: Parera-Arranz
authors.forename: Pau
authors.initials: P
authors.lastname: Romera-Romera
authors.forename: Jordi
authors.initials: J
authors.lastname: Castellvi-Manent
authors.forename: Antoni
authors.initials: A
authors.lastname: Sabala-Llopart
authors.forename: Julio
authors.initials: J
authors.lastname: de la Cámara-Hermoso
mesh_terms: D000368:Aged; D001082:Aqueous Humor / Q000378:metabolism; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D053844:Lasers, Solid-State; D008297:Male; D008689:Methacrylates; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012590:Sclera / Q000378:metabolism / Q000601:surgery*; D012599:Sclerostomy / Q000379:methods*; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014602:Uvea / Q000378:metabolism / Q000601:surgery*
chemical_list: D008689:Methacrylates; C005044:hydroxyethyl methacrylate
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