Abstract
Abstract: :
Purpose: To prospectively compare the results of Deep sclerectomy(DS) versus deep sclerectomy with collagen implant(DSCI) Methods: Randomised prospective trial involving 26 eyes (13 patients) with medically uncontrolled primary and secondary open angle glaucoma. Collagen implant was randomly assigned to one eye of each patient. Results: Mean follow-up period was 49.5 (SD 20) months for the DS group, and 56.5(SD 14) months for the DSCI group (P=0.4). The mean preoperative IOP was 24.1(SD 7)mmHg for the DS group, and 25.3(SD 6)mmHg for the DSCI group (P=0.5). The mean IOP at the first postoperative day was 6.4(SD 3) mmHg for the DS group, and 3.7 (SD 2) mmHg for the DSCI group(P=0.05). The mean IOP at 12 months postoperative day was 15.4(SD 3) mmHg for the DS group, and 10.4 (SD 4) mmHg for the DSCI group(P=0.04), while at 48 months it was 16(SD 3) mmHg for the DS group, and 10 (SD 4) mmHg for the DSCI group (P=0.005). Complete success rate, defined as IOP lower than 21 mmHg without medication, was 38 % (5/13 patients) at 48 months for the DS group, and 69 % (9/13 patients) for the DSCI group. Qualified success rate; patients who achieved IOP below 21 mmHg with or without medication, was 69 % (9/13 patients) at 48 months and 100 % (13/13 patients) for the DSCI group. Mean number of medications was reduced from 2.4(SD 0.8) to 1.1(SD 1) after DS, and was reduced from 2.2(SD 0.7) to 0.4(SD 0.6) in the DSCI group(P=0.001) Conclusion: The use of a Collagen implant in DS seems to enhance the success rates and lower the need for postoperative medications.