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Non-penetrating deep sclerectomy without or with autologous scleral implant in open-angle glaucoma: medium-term results.

Devloo S, Deghislage C, Van Malderen L, Goethals M, Zeyen T

Department of Ophthalmology, Middelheim Hospital, Antwerp, Belgium. sylviedevloo@yahoo.com

BACKGROUND: This study compares the medium-term success rate and complications of non-penetrating deep sclerectomy (NPDS) without and with autologous scleral implant in open-angle glaucoma. METHODS: Retrospective review of 93 eyes of 93 patients with medically uncontrolled open-angle glaucoma who underwent NPDS without (n=69, group 1) or with (n=24, group 2) autologous scleral implant. RESULTS: The mean follow-up was 16 months (range 5-36) in group 1 and 15 months (range 4-28) in group 2. The mean intra-ocular pressures (IOP) pre- and postoperatively were, respectively, 23.8 and 16.1 mmHg in group 1, and 25.6 and 15.8 mmHg in group 2. The absolute success rate was 41% in group 1 and 54% in group 2. The qualitative success rate was 83% in group 1 and 75% in group 2. An IOP lower than 16 mmHg was obtained in 51% of patients in group 1 and 58% of patients in group 2. A Nd:YAG laser goniopuncture was performed in 30% of patients in group 1 and 50% of patients in group 2, and resulted in a better controlled IOP. CONCLUSIONS: NPDS without or with an autologous scleral implant is a safe procedure reducing the IOP significantly, but probably not sufficient when an IOP below 16 mmHg is required. We found no statistically significant difference between the two groups.

Published 29 November 2005 in Graefes Arch Clin Exp Ophthalmol, 243(12): 1206-12.
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