Deep sclerectomy with collagen implant: medium term results

Details

Serval ID
serval:BIB_9C594B01A760
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Deep sclerectomy with collagen implant: medium term results
Journal
British Journal of Ophthalmology
Author(s)
Karlen  M. E., Sanchez  E., Schnyder  C. C., Sickenberg  M., Mermoud  A.
ISSN
0007-1161 (Print)
Publication state
Published
Issued date
01/1999
Volume
83
Number
1
Pages
6-11
Notes
Clinical Trial
Journal Article --- Old month value: Jan
Abstract
AIMS: To study prospectively the success rate and complications of deep sclerectomy with collagen implant (DSCI), a new non-penetrating filtration procedure. METHODS: Non-randomised prospective trial involving consecutive patients. 100 eyes of 100 patients with medically uncontrolled primary and secondary open angle glaucoma. A superficial scleral flap was raised and a deep sclerectomy was performed in the scleral bed. Schlemm's canal was opened and dissection of the cornea was performed up to Descemet's membrane, at which point aqueous percolated through the remaining trabeculo-Descemet's membrane. A collagen implant was sutured radially in the scleral bed. Visual acuity, intraocular pressure (IOP) measurements, and slit lamp examinations were performed before surgery and after surgery at 1 and 7 days, and 1, 3, 6, 9, 12, 18, 24, 30, and 36 months. RESULTS: The mean follow up period was 17.8 (SD 8.7) months. The mean preoperative IOP was 27.8 (8.6) mm Hg; the mean postoperative IOP was 5.7 (4.0) at day 1, 11.2 (4.6) at month 1, 14.0 (3.5) at month 12, and 13.0 (3.8) at month 36. Complete success rate, defined as an IOP lower than 21 mm Hg without medication, was 44.6% at 36 months. Qualified success rate, defined as an IOP lower than 21 mm Hg with medication, was 97.7% at 36 months. Early postoperative complications included hyphaema in seven patients, would leak in 10 patients, and subtle choroidal detachment in 11 patients. Goniopuncture was performed in 41 of the patients, and 5-fluorouracil injections were made in 23 patients; cataract progression occurred in seven patients. When comparing the different types of open angle glaucoma, no difference was found in terms of reduction in IOP, number of patients requiring antiglaucoma medications, or success rate. CONCLUSIONS: Deep sclerectomy with collagen implant appears to provide reasonable control of IOP at medium term follow up, with few immediate postoperative complications.
Keywords
Aged Collagen/*therapeutic use Female Fibrosis Fluorouracil/therapeutic use Glaucoma, Open-Angle/*surgery Humans Male Postoperative Complications/drug therapy Prospective Studies *Prostheses and Implants Scleroplasty/*methods Treatment Outcome Visual Acuity
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 13:49
Last modification date
20/08/2019 16:03
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