title: Deep sclerectomy in primary open-angle glaucoma and exfoliative glaucoma.
abstract: OBJECTIVE
  To study the effect of deep sclerectomy (DS) in primary open-angle glaucoma (POAG) and exfoliative glaucoma (EXG).
  
  
  METHODS
  We retrospectively analyzed the intraocular pressure (IOP)-lowering effect of DS in 235 consecutive eyes. Eyes were divided into 2 groups according to glaucoma subtype: POAG (127 eyes) and EXG (108 eyes). Postoperative IOP was the main outcome measurement. We recorded complete and qualified surgical success, need for YAG-laser goniopuncture, and need for postoperative glaucoma medication. We studied factors related to outcome of surgery in a Cox regression model.
  
  
  RESULTS
  In the POAG group, the mean (SD) IOP decreased from 22.6 (5.1) mm Hg preoperatively to 16.8 (7.5) mm Hg, with qualified success achieved in 70% of eyes. Postoperatively, 57% were without medication. In the EXG group, IOP decreased from 25.5 (6.5) mm Hg preoperatively to 16.5 (7.8) mm Hg postoperatively, with qualified success achieved in 66% of eyes. Postoperatively, 50% were without medication. Decrease in IOP was statistically significant in both groups (p&lt;0.001). In the POAG group, 12%, and in the EXG group, 24% needed a reoperation in the follow-up period (p = 0.037). In the Cox regression model, 1 week IOP between 2 and 14 mm Hg without medication lowered the hazard rate of losing complete success by 34% (p = 0.031) and the hazard rate of losing qualified success by 54% (p = 0.004).
  
  
  CONCLUSIONS
  The IOP 1 week postoperatively seems to be a prominent indicator of surgical success. Deep sclerectomy is effective in reducing IOP in POAG and EXG subgroups, with reoperations more common in EXG eyes.
authors.affiliation: Department of Ophthalmology, Helsinki University Central Hospital, Helsinki - Finland.
authors.forename: Sakari M A
authors.initials: SM
authors.lastname: Suominen
authors.affiliation: Department of Ophthalmology, Helsinki University Central Hospital, Helsinki - Finland.
authors.forename: Mika P
authors.initials: MP
authors.lastname: Harju
authors.affiliation: Department of Ophthalmology, Turku University Central Hospital, Helsinki - Finland.
authors.forename: Eija T
authors.initials: ET
authors.lastname: Vesti
mesh_terms: D000368:Aged; D017889:Exfoliation Syndrome / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017075:Laser Coagulation; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D012599:Sclerostomy; D014065:Tonometry, Ocular; D016896:Treatment Outcome