Abstract
Abstract: :
Purpose: To report the initial results of non–penetrating deep sclerectomy (NPDS) using the CO2 laser (OT–133, Optotech, Israel) in human eyes. Methods:NPDS was performed on 15 eyes of 15 patients in 3 centers (South Africa, Israel and India). Half of the patients were legally blind (VA<6/120). Laser was applied over the scleral bed to create a filtration pool, and over the trabecular meshwork until free fluid percolation was clearly evident. No tissue spacers or anti–metabolites were used. Results:Of the first 5 cases, 1 was converted to conventional trabeculectomy, 1 aborted because of closable angle, and 1 initially succeeded but vitreous hemorrhage recurred during follow up. In the rest mean preoperative intraocular pressure (IOP) was 31.6 mmHg. Mean IOP on day1, week 1 and week 2 was 5.5, 12.2 and 17 mmHg, respectively. At 2 weeks 73% of the patients maintained IOP <16 mmHg without medications. In all cases anterior chambers were deep and stable, and no laser related complications were recorded. Early PAS formation was a common finding. Conclusions: Initial clinical results of the CO2 laser NPDS indicate that it is a safe simplified technique to achieve effective fluid percolation. Surgical technique, and optimal parameters still need to be determined
Keywords: clinical (human) or epidemiologic studies: systems/equipment/techniques • laser • trabecular meshwork