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Suprachoroidal drainage with collagen sheet implant- a novel technique for non-penetrating glaucoma surgery

Graefe's Archive for Clinical and Experimental Ophthalmology volume 256, pages 381–385 (2018)Cite this article

Abstract

Purpose

Our purpose was both to introduce the new technique of suprachoroidal drainage with collagen sheet implantation as a novel technique of non-penetrating glaucoma surgery and to present first results of a prospective pilot study.

Methods

A superficial rectangular sclera flap of half-scleral thickness sized 4 × 4.5 mm is dissected anteriorly until clear cornea. Then, a second scleral flap is created underneath the first one sized 3.5x4mm and is cut down full-thickness to the choroid exposing the suprachoroidal space. The flap is then bluntly prepared until the scleral spur is reached. Sharp dissection above the sclera spur exposes Schlemm’s canal, which is located directly anteriorly. Schlemm’s canal is unroofed, juxtacanalicular meshwork is peeled and the deep flap is cut off at its base. An absorbable collagen sheet (Ologen®, Dahlhausen, Cologne, Germany) is placed into the suprachoroidal space at the level of the ciliary body, and the superficial sclera flap is sutured tightly to prevent leakage.

Results

We prospectively analyzed 65 eyes that underwent suprachoroidal drainage with collagen sheet implantation. Mean reduction of intraocular pressure after 3 months was 35.1% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.4 mmHg)(p < 0.01) and after 12 months 35.6% (from 21.0 ± 4.3 mmHg to 13.5 ± 3.0  mmHg)(p < 0.01). The number of topical IOP-reducing medication decreased significantly from 3.5 ± 0.7 to 0.6 ± 0.9 and to 0.9 ± 1.1 after 3 and 12 months, respectively (p < 0.01). No serious complications occurred.

Conclusion

Suprachoroidal drainage with collagen sheet implantation seems to be a safe and effective surgical technique for non-penetrating glaucoma surgery that yields the opportunity of a sufficient IOP reduction for eyes unsuitable for canaloplasty.

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Saar, Germany

    Peter Szurman, Kai Januschowski, Karl Thomas Boden & Anna-Maria Seuthe

  2. University Eye Clinic Tuebingen, Centre for Ophthalmology, Tuebingen, Germany

    Kai Januschowski

Authors
  1. Peter Szurman
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  2. Kai Januschowski
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  3. Karl Thomas Boden
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  4. Anna-Maria Seuthe
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Corresponding author

Correspondence to Anna-Maria Seuthe.

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with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent is not required.

This article does not contain any studies with animals performed by any of the authors.

Disclosure

Szurman (none), Januschowski (none), Boden (none), and Seuthe (none).

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Szurman, P., Januschowski, K., Boden, K.T. et al. Suprachoroidal drainage with collagen sheet implant- a novel technique for non-penetrating glaucoma surgery. Graefes Arch Clin Exp Ophthalmol 256, 381–385 (2018). https://doi.org/10.1007/s00417-017-3873-9

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  • DOI: https://doi.org/10.1007/s00417-017-3873-9

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