July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Nonpenetrating Deep Sclerectomy with Mitomycin C: 5 Year Follow-up with analysis of IOP control and Visual Field Survival
Author Affiliations & Notes
  • Grant Slagle
    Midwestern University, Westmont, Illinois, United States
  • William Eric Sponsel
    Vision Sciences, WESMDPA/UIW/UTSA, San Antonio, Texas, United States
  • Footnotes
    Commercial Relationships   Grant Slagle, None; William Sponsel, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 473. doi:
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    • Get Citation

      Grant Slagle, William Eric Sponsel; Nonpenetrating Deep Sclerectomy with Mitomycin C: 5 Year Follow-up with analysis of IOP control and Visual Field Survival. Invest. Ophthalmol. Vis. Sci. 2018;59(9):473.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To document longer term (5 year) outcomes of eyes treated with NPDS in a new consecutive patient cohort comparable to one we reported upon in 2013 that demonstrated clinically significant improvement in visual field status 6, 12, and 18 months after treatment with NPDS.

Methods : All eyes of patients undergoing planned NPDS surgery between January 2008 and June 2012 were included. Each tracked variable (IOP, number of anti-glaucoma medications, MD, and CPSD) was statistically evaluated and compared to the relevant pre-operative baseline value using two-tailed paired Student’s t-test. In all instances, comparisons were made only comparing baseline values that were directly related to the same precise cohort of eyes being followed up at each time interval.

Results : 122 eyes underwent NPDS filtering surgery with MMC. Reduction of IOP and anti-glaucoma medication was noted at every postoperative interval up to and including 5 years. Mean IOP with standard error of the mean was 19.7 ±0.5 mmHg preoperatively, 11.9 ±0.5 at 3 months postoperative, 12.5 ±0.6 at 6 months, 12.4 ±0.5 at 12 months, 12.6 ±0.6 at 18 months, 11.1 ±0.6 at 2 years, 11.8 ±0.5 at 2.5 years, 11.0 ±0.5 at 3 years, 11.7 ±0.5 at 3.5 years, 10.7 ±0.7 at 4 years, 11.6 ±0.5 at 4.5 years, and 12.4 ±0.7 at 5 years. For the final data point at 5 years post-operation, this corresponds to an average IOP reduction of 7.8 mmHg or 37% (p < 10-6); 92% had stable IOP ≥5 and ≤21mmHg at 5 years. Mean number of preoperative anti-glaucoma medications was 2.7 ±0.1, reduced to 0.40 ±0.09 three months postoperatively, 0.51 ±0.1 at 6 months, 0.38 ±0.08 at 12 months, 0.49 ±0.09 at 18 months, 0.41 ±0.09 at 2 years, 0.39 ±0.09 at 2.5 years, 0.49 ±0.1 at 3 years, 0.58 ±0.1 at 3.5 years, 0.49 ±0.1 at 4 years, 0.64 ±0.1 at 4.5 years, and 0.52 ±0.1 at 5 years. At five years this corresponded to an average reduction of 2.2 medications (81%), with a p value <10-22.

Conclusions : This study indicates that with adequate post-operative management, eyes that have undergone NPDS can maintain adequate IOP control, require low or no medication use, and function with relatively stable visual fields for an extended period of time.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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