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E. Blumen–Ohana, A. Regis–Mottier, N. Hamelin–Gervais, J.P. Nordmann; UBM as a Tool to Predict Glaucoma Non–Penetrating Filtration Surgery . Invest. Ophthalmol. Vis. Sci. 2005;46(13):101.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the intra ocular pressure lowering mechanisms of deep sclerectomy using ultrasound biomiocroscopy (UBM) and detect ultrasound characteristics associated to good surgical prognosis. Methods: We conducted a retrospective study on 31 eyes of 25 patients suffering from primary open angle glaucoma. All patients failed medical therapy and underwent deep sclerectomy. All procedures were performed by one surgeon using an identical surgical technique. We considered surgery was successful if postoperative intraocular pressure was found below 20 mm Hg without any additional medical treatment. An UBM examination was undertaken at least three months after surgery looking at the aspect of the site of deep sclerectomy, the importance of the decompression space, the characteristics of the filtering bleb and presence/absence of a supracilliary hypoechogenic area. Results: Mean age of the patients was 62.3 years. Surgery was successful in 74.2% of the eyes. UBM examination was performed with a mean of 9.4 months after the procedure. Decompression space visualization, hypoechogenicity around the scleral flap, a filtration bleb with low echogenicity , a supracilliary hypoechogenic area, were found respectively in 100%, 78.2%, 78% and 61% of the successful cases. Conclusions: UBM confirmed that deep sclerectomy facilitates the aqueous outflow by weakening the resistance sites of the trabecular meshwork. It creates a bleb filtration through a decompression space. UBM was found to be a good tool to underline different elements linked with successful surgery, in particular visualization of the decompression space.
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