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Viscocanalostomy with and without Implantation of Reticulated Hyaluronic Acid
Lüke C., Dietlein T., Jacobi P. C., Konen W., Krieglstein G. K.,
Universität zu Köln, Zentrum für Augenheilkunde (Köln)
Purpose: To assess prospectively the efficacy and complications of deep sclerectomy with a reticulated hyaluronic acid implant versus standard viscocanalostomy in patients with medically uncontrolled open-angle glaucoma.
Method: A consecutive series of 40 patients (40 eyes) with uncontrolled open-angle glaucoma underwent nonpenetrating antiglaucomatous surgery. After the excision of the deep scleral flap the patients were assigned randomly to receive either a standard viscocanalostomy or implantation of a reticulated hyaluronic acid implant. Follow-up visits were applied over a period of 12 months after surgery.
Results: The mean preoperative intraocular pressure (IOP) was 26.5 (SD 6.1) mmHg for all patients enrolled. One day post surgery the mean IOP was 8.1 mmHg (SD 5.6) for the viscocanalostomy group (p<0.001) and 12.0 (SD 5.2) for the DSRHAI group (p<0.001). The postoperative IOP-difference between the two groups was statistically significant (p = 0.03). The success rate, defined as an IOP lower than 22 mmHg without medication, was 40 % in both groups at 12 months postoperatively (p = 0.90). The number of postoperative complications was equally low for both groups.
Conclusions: Both surgical procedures, viscocanalostomy and DSRHAI, provide comparable success rates over a one-year follow-up period. The overall rate of postoperative complications proved equally low for both techniques. However the frequency of postoperative hypotony was lower in the DSRHAI group.