May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Deep Sclerectomy 10 Years Later: A Retrospective Chart Review
Author Affiliations & Notes
  • S. A. Gandolfi
    Ophthalmology, University of Parma, Parma, Italy
  • N. Ungaro
    Ophthalmology, University of Parma, Parma, Italy
  • C. Sangermani
    Ophthalmology, University of Parma, Parma, Italy
  • M. Tardini
    Ophthalmology, University of Parma, Parma, Italy
  • G. Bacchi
    Ophthalmology, University of Parma, Parma, Italy
  • Footnotes
    Commercial Relationships  S.A. Gandolfi, None; N. Ungaro, None; C. Sangermani, None; M. Tardini, None; G. Bacchi, None.
  • Footnotes
    Support  FIL 2006
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4175. doi:https://doi.org/
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      S. A. Gandolfi, N. Ungaro, C. Sangermani, M. Tardini, G. Bacchi; Deep Sclerectomy 10 Years Later: A Retrospective Chart Review. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4175. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : to evaluate the longterm outcome of deep sclerectomy in several glaucoma phenotypes

Methods: : retrospective chart review. The charts of 124 patients scheduled for primary deep sclerectomy and operated in the period January 1999 - December 2004 were analyzed. Main outcomes (a) complete success = % of patients showing IOP <,16 mmHg, w/out therapy, on Goldmann applanation tonometry performed at similar daytime, (b) post-operative medications, (c) number of further glaucoma surgical procedures. Surgery was performed by the same surgeon. Goniopuncture was considered as a part of the procedure. Peeling of internal TM was recorded from the OP reports.

Results: : 27 / 124 patients were either lost-to-follow up or ineligible because of intra-operative complications (i.e. micro or macroperforations). 97 patients were still followed by our Glaucoma Clinic. Mean follow up time was 5.3 + 2.6 years (range 3 - 8 years). The glaucoma phenotypes were the following: (a) POAG n = 31, (b) PEX n = 34, (c) PG n = 9, (d) uveitic n = 11, (e) AC IOLs = 12,, Mean (SD) pre-op IOP was 24.3 (2.6). Mean (SD) IOP dropped to 14.3 (2.1) at the end of follow up. Goniopuncture was performed in 64 / 97 patients. Complete success was obtained in 24/97 patients. Complete succes was significantly associated with (a) immediate post-op IOP < 8 mmHg , (b) reported peeling of the TM, 14 / 97 were scheduled for further glaucoma surgery. Cataract extraction was performed in 9 / 58 phakic patients. Previous 360° laser trabeculoplasty, PG and PEX phenotype, further cataract surgery and number of pre-op medications were independent risk factors for failure. 2 patients developed a post-operative delayed suprachoroidal hemorrage. Both of them showed high myopia and were apakic.

Conclusions: : In the long-term, deep sclerectomy proved moderately effective in this uncontrolled case series. Peeling of the internal TM seems mandatory to obtain clinically relevant success.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications 
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