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O Arend, N Plange, A Remky, C Redbrake; Influence on Intraocular Pressure Following Deep Non Pentrating Sclerectomy and Viscocanalostomy in Combination With Amnion Implant and/or 5 Fluorourcil Application in Glaucoma Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3364.
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Purpose: The drainage of aqueous humor after deep non penetratingsclerectomy and viscocanalostomy (VCS) might be the result ofa dilatation of Schlemm canal, episcleral vein outflow or subconjunctivalfiltration. However, the intraocular pressure (IOP) loweringeffect of VCS in caucasians is less effective than followingtrabeculectomy. Modulating postsurgical healing seems admirable.In this study, the VCS was modified by adding an amnion implantunder the scleral flap, or adding 5 Fluorouracil (5 FU: 35 mg)during surgery, and the combination of both.Method: Thirtyeight patients with open angle glaucoma underwent VCS as describedby R. Stegman (group1). In a prospective, randomized study thetechnique was modified by adding 5FU (group 2; n=10), addingan amnion implant (group 3; n=9), and the combination of both(group 4; n=11).Results: Six weeks post surgery there wereno significant differences among groups regarding IOP efficacy(p<0.01). Group 1 showed a significant difference betweenpatients with a filtering bleb and those with an intrascleralreservoir (p<0.05; 15 ±6 mmHg vs. 20 ±7 mmHg).IOP success criteria are listed 6 weeks after surgery.Conclusion:Deep non pentrating sclerectomy with viscocanalostomy reducessignificantly intraocular pressure. A postsurgical filteringbleb seems beneficial for IOP lowering efficacy. The post surgicalhealing process can be influenced by amnion implant and applicationof 5 FU although significance failed in this study with a smallnumber of patients. View OriginalDownload SlideView OriginalDownload Slide View OriginalDownload SlideView OriginalDownload Slide
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