Abstract
The aim was to report the results of deep sclerectomy (DS) with supraciliary hema implant and the influence of the surgical complications on intraocular pressure (IOP). Forty-eight eyes of 41 patients with open angle glaucoma (OAG), who underwent DS with supraciliary hema implant (Esnoper® V-2000), were included in this study. A significant IOP reduction was observed, changing from a preoperative mean of 24.6 ± 6.33 mmHg to 16.5 ± 4.4 mmHg (p < 0.001) at 12 months and 16.1 ± 3.4 mmHg (p < 0.001), at 24 months. Similarly, a significant reduction in the number of glaucoma drugs needed was observed, varying from 2.71 to 0.22 (p < 0.001) and 0.4 (p < 0.001), 1 and 2 years after surgery. Goniopuncture with the Nd:Yag Laser was performed in 30 eyes (62.5 %) with a mean time between the surgery and the procedure of 150 days, producing a mean IOP reduction of 4.0 mmHg (p < 0.001). The main intraoperative complications were microperforation of the trabeculodescemetic membrane (TDM) in 1 eye (2.08 %) The main early postoperative complications were seidel at 24 h in 11 eyes (22.91 %), hyphema in 7 eyes (14.58 %), choroidal detachment in 3 eyes (6.25 %) with macular folds in 2 (4.16 %) and need for additional mitomycin injections in 2 eyes (4.16 %). All these complications were spontaneously resolved. No correlation between these complications and final IOP was found, but a significant correlation between the presence of hyphema and higher IOP 24 months postoperatively (p = 0.048) was observed. DS with supraciliary hema implant is a safe and effective technique for the management of OAG. The presence of hyphema during the first week after the surgery could be considered as a negative prognostic factor in DS with supraciliary implantation.
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References
Muñoz G (2009) Nonstitch suprachoroidal technique for T-flux implantation in deep sclerectomy. J Glaucoma 18:262–264
Bonilla R, Loscos J, Valldeperas X, Parera MA, Sabala A (2012) Supraciliary hema implant in combined deep sclerectomy and phacoemulsification: one year results. Open Ophthalmol J 6:59–62
Mermoud A, Shaarawy T (2001) Non penetrating glaucoma surgery. Martin Dunitz, London, p 97
Development Core Team (2011) A language and environment for statistical computing. R foundation for statistical computing, Vienna, Austria. http://www.R-project.org/. Accessed May 2012
Cheng JW, Ma XY, Wei RL (2004) Efficacy of non-penetrating trabecular surgery for open angle glaucoma: a meta-analysis. Chin Med J. (Engl) 117:1006–1010
Lachkar Y, Neverauskiene J, Jeanteur-Lunel MN et al (2004) Nonpenetrating deep sclerectomy: a 6-year retrospective study. Eur J Ophthalmol 14:26–36
Ravinet E, Bovey E, Mermoud A (2004) T-Flux implant versus Healon GV in deep sclerectomy. J Glaucoma 13:46–50
Leszczyński R, Formińska-Kapuścik M, Bubała-Stachowicz B, Mrukwa-Kominek E, Filipek E, Pawlicki K (2012) Nonpenetrating very deep sclerectomy with hyaluronic acid implant vs trabeculectomy—a 2-year follow-up. Graefes Arch Clin Exp Ophthalmol 250:1835–1841
Grieshaber MC, Schoetzau A, Flammer J, Orgül S (2013) Postoperative microhyphema as a positive prognostic indicator in canaloplasty. Acta Ophthalmol 91(2):151–156
Koch JM, Heiligenhaus A, Heinz C (2011) Canaloplasty and transient anterior chamber haemorrhage. A prognostic factor? Klin Monbl Augenheilkd 228:465–467
Hamel M, Shaarawy T, Mermoud A (2001) Deep sclerectomy with collagen implant in patients with glaucoma and high myopia. J Cataract Refract Surg 27:1410–1417
Konstas AG, Jay JL (1992) Modification of trabeculectomy to avoid postoperative hyphaema. The ‘guarded anteriorfistula’ operation. Br J Ophthalmol 76:353–357
Coob CJ, Chakrabarti S, Chadha V, Sanders R (2007) The effect of aspirin and warfarin therapy in trabeculectomy. Eye 21:598–603
Figus M, Bartolomei MP, Lazzeri S, Nardi M (2011) Very deep sclerectomy. J Glaucoma 20:67
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Loscos, J., Valldeperas, X., Langhor, K. et al. Deep sclerectomy with supraciliary hema implant (Esnoper® V-2000): results and complications. Int Ophthalmol 35, 693–699 (2015). https://doi.org/10.1007/s10792-015-0037-y
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DOI: https://doi.org/10.1007/s10792-015-0037-y