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R.E. Bendel; Survey of Nonpenentrating Glaucoma Surgery Utilization by Members of the American Glaucoma Society . Invest. Ophthalmol. Vis. Sci. 2005;46(13):104.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the percentage of glaucomatologists who perform nonpenetrating glaucoma surgery as part of their surgical treatment of glaucoma. Methods: An email survey was sent to members of the American Glaucoma Society and the investigator collected responses confidentially. The doctors were asked if they performed viscocanalostomy and/or nonpenetrating deep sclerectomy (NDS) and what their experience has been with the procedures. Of 150 messages sent, 82 members responded. Results: 1. 16% (13/82) perform some nonpenetrating glaucoma surgery (NPS). 2. 11% (9/82) of all respondents do only one of the procedures, or 69% (9/13) of the 13 performing some NPS: – 4/13 do NDS only, 3 use the Aqua–Flow System®, one uses no implant – 5/13 do viscocanalostomy only. The range of procedures per surgeon is from 2 to 150 cases/year 3. Doctors performing both procedures is 5% (4/82), or 31% (4/13) of the 13 who do NPS. All used the Aqua–Flow implant, one with MMC, when performing NDS. The respondents stated NPS is 5 to 15% of all glaucoma surgery performed in their practices. 4. 2 doctors did not perform NPS, but referred their patients to another surgeon to perform the procedure. 5. 8.5% (7/82) have performed the procedures at one time, but no longer do NPS. The primary reasons are an overall lack of being impressed with the reduction of intraocular pressure, unpredictable failure, need for repeated laser goniopuncture post–operatively and the indications for NPS are quite limited. Conclusions: Practice patterns of nonpenetrating glaucoma surgery reflect the body of evidence in the literature. To get a lower IOP most surgeons prefer trabeculectomy. A minority of glaucomatologists performs NPS, and those who do perform NPS do so only in cases of early glaucoma.
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