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J Cataract Refract Surg. 1999 Mar;25(3):323-31.

Comparison of deep sclerectomy with collagen implant and trabeculectomy in open-angle glaucoma.

Author information

1
Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland.

Abstract

PURPOSE:

To assess the efficacy and postoperative complications of deep sclerectomy with collagen implant (DSCI), a nonpenetrating filtration procedure.

SETTING:

Glaucoma Unit, Department of Ophthalmology, University of Lausanne, Switzerland.

METHODS:

Forty-four eyes of 44 patients with medically uncontrolled open-angle glaucoma had DSCI and a matched control group of 44 patients, trabeculectomy. A superficial scleral flap was raised and a deep sclerectomy performed in the scleral bed. Schlemm's canal was opened, and the cornea was dissected to Descemet's membrane. At that stage, aqueous filtered through the remaining trabeculo-Descemet's membrane. A collagen implant was sutured radially in the scleral bed; the scleral flap and conjunctiva were then closed. Examinations were performed before surgery and postoperatively at 1 and 7 days and 1, 2, 3, 6, 9, 12, 15, 18, and 24 months.

RESULTS:

The mean follow-up was 14.4 months +/- 6.3 (SD) (range 3 to 24 months). The mean preoperative intraoperative pressure (IOP) was 26.7 +/- 7.3 mm Hg. The mean postoperative IOP was 6.1 +/- 4.5 mm Hg at 1 day and 11.0 +/- 4.4 mm Hg at 1 week; it remained stable for the next 24 months. The success rate, defined as an IOP lower than 21.0 mm Hg without medication, was 69% in the DSCI group and 57% in the trabeculectomy group at 24 months postoperatively (P = .047). The number of postoperative complications was significantly lower in the DSCI group than in the trabeculectomy group.

CONCLUSIONS:

The success rate of DSCI may be comparable to that of trabeculectomy, with fewer complications.

Comment in

PMID:
10079436
DOI:
10.1016/s0886-3350(99)80079-0
[Indexed for MEDLINE]

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