Abstract
Abstract: :
Purpose: To compare the outcome of phacoemulsification combined with deep sclerectomy with collagen implant (P-DS) with that of deep sclerectomy with collagen implant (DS) alone. Setting: Glaucoma Unit, Department of Ophthalmology, University of Lausanne, Switzerland. Methods: This retrospective study involved 166 eyes of 166 patients with primary and secondary open angle glaucoma, 83 patients underwent DS and 83 patients underwent P-DS. Follow-up was performed at regular intervals for up to 72 months. Both groups were matched for preoperative intraocular pressure, age, sex and mean follow-up. Results: Mean follow-up was 27.3 (SD 18) months and 27.9 (SD 16) months for the P-DS and DS groups respectively. Mean preoperative intraocular pressure (IOP) was 23.3(SD 7) for P-DS and 23.6 (SD 4) mmHg for DS. There was a statistically difference in IOP decrease during the first day post-operatively (9.8 mmHg in P-DS vs 4.8 mmHg in DS, P<0.001). From the third month post-operatively the difference between IOP decrease in P-DS and DS was not statistically different, achieving IOP of 13.7(SD 4) mm Hg for the P-DS and 13.1(SD 3.2)mm Hg for the DS group at 24 months. Final mean visual acuity was similar in both groups 24 months post-operatively (0,62 in P-DS and 0.64 in DS) Complete success rate, defined as IOP lower than 21 mmHg without medication, was 58 % (48/83 patients) at 36 months for the DS group, and 57% (45/83 patients) for the P-DS group. Qualified success rate; patients who achieved IOP below 21 mmHg with or without medication, was 93 % (77/83 patients) at 36 months for the DS group and 94 % (78/83 patients) for the P-DS group The main complications observed postoperatively included anterior chamber inflammation, postoperative hypertension and hypotension, hyphema, Dellen and Seidel. Conclusion: DS combined with cataract surgery resulted in a IOP reduction and a visual outcome similar to that with DS in a medium term follow-up.