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WGW-2021

Abstract #81099 Published in IGR 20-3

Modified Deep Sclerectomy for the Surgical Treatment of Glaucoma

Sharifipour F; Yazdani S; Asadi M; Saki A; Nouri-Mahdavi K
Journal of ophthalmic & vision research 2019; 14: 144-150


PURPOSE: To report the short-term outcomes of modified deep sclerectomy (MDS) in the management of open angle glaucoma. METHODS: This prospective, non-randomized, controlled study included 105 eyes (105 patients) with open angle glaucoma. Eyes were categorized as follows: trabeculectomy (30 eyes), MDS (27 eyes), phacotrabeculectomy (28 eyes), and phaco-MDS (20 eyes). The MDS technique involved removal of a third scleral flap to expose the suprachoroidal space and excision of a trabecular block. A two-site approach was used for combined surgeries. Main outcome measures included intraocular pressure (IOP), number of glaucoma medications, and complications. Treatment success was defined as an IOP of 6-15 mmHg and/or a 30% reduction in IOP. RESULTS: All groups showed significant decrease in IOP and number of medications (both s < 0.001). The MDS group had a higher IOP (13.9 ± 3.8 vs. 12.4 ± 2.5 mmHg, = 0.080) and required more medications ( = 0.001) than the trabeculectomy group at 1 year. The MDS group had a higher baseline IOP than the trabeculectomy group ( = 0.004) and both the groups showed similar IOP reductions (33.3% vs. 25.7%, = 0.391). The phaco-MDS and phacotrabeculectomy groups had comparable IOP (13.3 ± 3.1 vs. 12.4 ± 3.1 mmHg, = 0.354), number of medications ( = 0.594), and IOP reduction ( = 0.509) at 1-year follow-up visit. The trabeculectomy and phacotrabeculectomy groups developed more wound leaks ( = 0.043) and required more bleb needling during the early postoperative period ( < 0.001). CONCLUSION: The MDS technique seems to be slightly inferior to trabeculectomy, but when combined with phacoemulsification, is safer and results in similar IOP outcomes.

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Classification:

12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)



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