An ultrasound biomicroscopic study of eyes after deep sclerectomy with collagen implant

Details

Serval ID
serval:BIB_91F5DE3BB068
Type
Article: article from journal or magazin.
Collection
Publications
Title
An ultrasound biomicroscopic study of eyes after deep sclerectomy with collagen implant
Journal
Ophthalmology
Author(s)
Chiou  A. G., Mermoud  A., Underdahl  J. P., Schnyder  C. C.
ISSN
0161-6420 (Print)
Publication state
Published
Issued date
04/1998
Volume
105
Number
4
Pages
746-50
Notes
Journal Article --- Old month value: Apr
Abstract
OBJECTIVE: This study aimed to assess the natural history of eyes after deep sclerectomy with collagen implant (DSCI), a nonperforating glaucoma-filtering surgery. DESIGN: The design was a prospective, longitudinal, observational, and nonrandomized study. PARTICIPANTS: Forty-five eyes of 41 patients with medically uncontrolled open-angle glaucoma were studied. INTERVENTION: Deep sclerectomy with collagen implant was performed. MAIN OUTCOME MEASURES: Ultrasound biomicroscopy (UBM) of the sclerectomy site was performed 1, 2, 3, 6, 9, 12, and 18 months after surgery. The following parameters were assessed: length and height of the collagen implant, thickness of the residual trabeculodescemetic membrane, and bleb appearance. RESULTS: Mean intraocular pressure decreased from a preoperative value of 26.3 +/- 3.5 mmHg (mean +/- standard deviation) to a postoperative value of 16.6 +/- 3.1 mmHg (mean +/- standard deviation) at 18 months (P < 0.001). The UBM findings showed a subconjunctival filtration with a nonperforated thin trabeculodescemetic membrane. In 23 eyes (51%), a hypoechoic area in the suprachoroidal space was observed. The thickness of the trabeculodescemetic membrane was stable throughout the study with a mean value of 0.13 mm +/- 0.02 (mean +/- standard deviation) at 18 months. The collagen implant dissolved slowly within 6 to 9 months, leaving a tunnel in the sclera. CONCLUSIONS: The UBM findings are consistent with intraocular pressure lowering by aqueous filtration through the thin remaining trabeculodescemetic membrane to an area under the scleral flap, which was maintained open by the collagen implant. The authors speculate that aqueous humor then reached the subconjunctival space and, eventually, was filtered through the thin scleral wall into the suprachoroidal space. Complete resorption of the collagen implant occurred between 6 and 9 months after surgery.
Keywords
Aged Aged, 80 and over Anterior Eye Segment/ultrasonography *Collagen Female Glaucoma, Open-Angle/etiology/surgery/*ultrasonography Humans Intraocular Pressure Longitudinal Studies Male Middle Aged Prospective Studies *Prostheses and Implants Sclera/surgery/ultrasonography *Sclerostomy Surgical Flaps
Pubmed
Web of science
Create date
28/01/2008 13:49
Last modification date
03/03/2018 19:30
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