Nonpenetrating deep sclerectomy versus trabeculectomy in bilateral primary open- angle glaucoma1Icce to phaco
Section snippets
Patients and methods
A total of 39 patients (78 eyes) with bilateral primary open-angle glaucoma underwent bilateral filtering surgery between October 1997 and March 1998.
Patients were assigned randomly to receive deep sclerectomy in one eye and trabeculectomy in the other; the surgeries were scheduled with no more than 3 days between the two procedures. Patients were included in the study if they had uncontrolled glaucoma (intraocular pressure [IOP] >21 mmHg) despite maximally tolerated medications. Excluded were
Results
Seventy-eight eyes of 39 patients were enrolled in the study. The mean ± standard deviation reported age of the patients was 53.4 ± 9.6 years (range, 38–75 years). Most patients were men (62.5%). Two patients were excluded from the study and were replaced because accidental perforation of the trabecula-Descemet’s membrane occurred during deep sclerectomy.
Preoperative and postoperative IOPs are shown in Table 1. There was a significant IOP reduction after surgery in both groups throughout the
Discussion
Nonpenetrating sclerectomy allows aqueous filtration from the anterior chamber to the subconjunctival space through a thin trabecula-Descemet’s membrane.15 This membrane avoids the sudden IOP drop, thus lowering the incidence of postoperative complications encountered with trabeculectomy.
Nonpenetrating filtration surgery was first proposed by Zimmerman et al.8, 9 Different techniques were described by others16, 17 with encouraging results. Fyodororv et al10 and Kozlov et al18 reported the use
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Prospective evaluation of penetrating deep sclerectomy in advanced open-angle glaucoma: Filtration surgery adapted to resource scarcity in developing countries
2020, Journal Francais d'OphtalmologieCitation Excerpt :This may be explained by the systematic long-term use of topical corticosteroids in the postoperative period, which was shown to have a significant protective effect against fibrosis, [21] and by the relatively short follow-up duration. The risk of postoperative iris incarceration in non-penetrating deep sclerectomy is approximately 5%, [22] which is believed to be due to micro-perforations in the trabeculo-Descemet membrane and can often be associated with physical effort in younger patients [23]. This is particularly relevant in the case of developing countries, as the average age of operated patients tends to be younger than in more industrialized countries.
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The authors have no proprietary or financial interest in any product of this study.