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David Berrones Medina, Alberto Hernández-Vargas, JESUS JIMENEZ-ARROYO, Armando Castillejos- Chévez, Jesus Jiménez-Roman; Non-penetrating deep sclerectomy versus trabeculectomy for open angle glaucoma in Mexican population.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2939.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the safety and effectiveness of non-penetrating deep sclerectomy (NPDS) surgery and conventional trabeculectomy in patients with open angle glaucoma and their complications.
Case series, prospective and longitudinal study of patients with medically uncontrolled open-angle glaucoma who underwent glaucoma surgery. They were divided in 2 groups, one treated with conventional trabeculectomy and the other with non-penetrating deep sclerectomy, each group with 13 eyes. We compared in both groups preoperative and postoperative intraocular pressure (IOP) at the first day, first month, six months and one year, best-corrected visual acuity (BCVA), visual field mean deviation, number of antiglaucomatous medications, and complication rates. The follow-up was one year after surgery. Data were analyzed with IBM SPSS® statistics v.21.
We included 26 eyes of twenty patients, 13 male (50%) and 13 female (50%). The mean age of the trabeculectomy group was 59 years (SD 11.01) and 62.84 years (SD 14.78) in the NPSD group; twenty four patients (92%) had primary open-angle glaucoma and two patients (8%) had secondary open-angle glaucoma. The mean BCVA for the trabeculectomy group was 0.16 logMAR, and 0.40 logMAR for the NPDS group. The preoperative IOP for the trabeculectomy group was 15.69 mmHg (SD 2.87) and 17.69 mmHg (SD 6.77) for the NPDS; the postoperative IOP at the first month was 11.76 mmHg (SD 1.76) in the trabeculectomy group and 11.18 mmHg (SD 2.78) in the NPDS group; at six months was 13.23 mmHg (SD 3.72) in the trabeculectomy group and 13.46 mmHg (SD 2.93) in the NPDS group; at one postoperative year, the IOP was 14.30 mmHg (SD 2.75) in the trabeculectomy group and 14.23 mmHg (SD 2.94) in NPDS group. No significance difference was found over time between the two groups (p >0.05). Few complications were found in both groups, no significance difference was found between them (p>0.05). Both groups required less antiglaucomatous medications, the difference was statistically significant between pre and post surgery medications (p<0.05) but there was no difference in the comparison between both groups (p>0.05).
Non-penetrating deep sclerectomy proved to be safe and an effective technique in open-angle glaucoma patients and the control of IOP was comparable with the trabeculectomy. Long term follow-up is needed to confirm our results.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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