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Nonpenetrating very deep sclerectomy with hyaluronic acid implant vs trabeculectomy — a 2-year follow-up

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Objective

To study and compare the efficacy and safety of nonpenetrating very deep sclerectomy (NPVDS) with the use of hyaluronic acid implant (SKGEL) to trabeculectomy (TB) in patients with with medically uncontrolled glaucoma.

Methods

Prospective, controlled study of patients with open-angle glaucoma was designed. Seventy-eight eyes of 68 patients with medically uncontrolled glaucoma were assigned either to the NPVDS or to the TB group of trial. Examinations were applied before and 7 days, 1, 3, 6, 12, 18, and 24 months after surgery.

Main outcome measure

Best-corrected logMAR visual acuity, intraocular pressure, number of additional procedures, antiglaucoma medications, number of complications.

Results

At 24 months, success rate defined as IOP ≤ 21 mmHg with medication and additional procedures in NPVDS group was 92.31 %, and 94.88 % in control group (p = 0.64). There was no statistically significant difference between intraocular pressure in NPVDS (14.56 ± 4.07 mmHg ) and control (TB) (15.38 ± 3.38 mmHg) group (p = 0.34). Number of glaucoma mediations decreased from 2.18 ± 0.56 to 0.54 ± 0.56 in NPVDS and from 2.28 ± 1.41 to 0.61 ± 0.03 in TB group (p = 0.71). Early and late postoperative complications included two cases of hyphema, two of choroidal detachment, two of filtering bleb fibrosis, four of cataract progression in the NPVDS group; and five cases of hyphema, four of choroidal detachment, one of filtering bleb fibrosis, one of blebitis, and 12 of cataract progression in the control group.

Conclusions

NPVDS is an effective surgical option for patients with medically uncontrolled glaucoma. NPVDS is associated with a lower risk of complications, and in particular cataract progression, compared to TB.

Application to clinical practice

NPVDS is a modification of NPDS devised for patients with medically uncontrolled open-angle glaucoma.

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Author contributions

Dr Rafał Leszczynski had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Financial disclosure

All authors have no financial interest or support.

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Authors and Affiliations

  1. Department of Ophthalmology, Medical University of Silesia, Katowice, Poland

    Rafał Leszczyński, Maria Formińska-Kapuścik, Beata Bubała-Stachowicz, Ewa Mrukwa-Kominek & Erita Filipek

  2. Department of Medical Biophysics, Medical University of Silesia, Katowice, Poland

    Krzysztof Pawlicki

  3. 43-190, Mikołów, Konopnickiej 72, Poland

    Rafał Leszczyński

Authors
  1. Rafał Leszczyński
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  2. Maria Formińska-Kapuścik
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  3. Beata Bubała-Stachowicz
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  4. Ewa Mrukwa-Kominek
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  5. Erita Filipek
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  6. Krzysztof Pawlicki
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Corresponding author

Correspondence to Rafał Leszczyński.

Additional information

Wanda Romaniuk and Andrzej Franek are Chiefs of the Departments to which the authors work.

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Leszczyński, R., Formińska-Kapuścik, M., Bubała-Stachowicz, B. et al. Nonpenetrating very deep sclerectomy with hyaluronic acid implant vs trabeculectomy — a 2-year follow-up. Graefes Arch Clin Exp Ophthalmol 250, 1835–1841 (2012). https://doi.org/10.1007/s00417-012-1985-9

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  • DOI: https://doi.org/10.1007/s00417-012-1985-9

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