Long Term Results After Deep Sclerectomy as Measured by Ultrasound Biomicroscopy (UBM)

Abstract

Abstract: : Purpose: To understand IOP lowering mechanisms after deep sclerectomy. Methods: Forty two eyes of thirty two patients with medically uncontrolled open angle glaucoma were studied. Complete ocular examination and Ultrasound Biomicroscopy (UBM) of the filtrating site were performed at least one year after surgery. The following parameters have been assessed: 1. subconjunctival filtering bleb, 2. presence and volume of an intrascleral bleb, 3. presence of suprachoroidal aqueous. Results: The intraocular pressure (IOP) decreased significantly from 28.1 +/- 2.5 mmHg to14.3 +/- 3.8 mmHg. UBM demonstrated a subconjunctival space in all eyes. In 39 eyes we observed an intrascleral cavity. The mean volume of this space was 1.8 mm₃ (range 0.11 mm₃ - 6.53 mm₃). In 19 eyes UBM demonstrated a suprachoroidal space. Conclusion: Several pathways for aqueous outflow could be presumed by UBM examination. All eyes showed a subconjunctival filtering bleb. In almost half of the patients suprachoroidal outflow was observed and 92% had a remaining intrascleral cavity more than one year after surgery.

Keywords: 503 outflow: trabecular meshwork • 432 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 444 intraocular pressure