Non-penetrating Deep Sclerectomy in Open-angle Glaucomas - A Retrospective Study

¹Hudde T., ¹Gündüz G., ¹Kremmer S., ²Heinz C., ³Steuhl K. P.,
¹Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde (Essen)
²Uni-Essen (Essen)
³Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde, Abt. für Erkrankungen des vorderen Augenabschnitts (Essen)

Purpose: Nonpenetrating surgical techniques in open angle glaucomas are now frequently in use. Success rates are controversial in the literature. We therefore examined all 81 eyes (75 patients) who underwent deep sclerectomy since 1998.
Methods: Retrospective study of patient files, follow up examinations and phone enquiry of referring ophthalmologists.
Results: Mean follow up time was 9.7 months (0-34 months). Successful (IOP < 21 mmHg without IOP lowering medication) were 45 operations (from them 39 >30% IOP reduction; preoperative mean IOP 24.7 [range 10-59] mmHg; at last follow up visit mean 12.6 [3-20] mmHg). A qualified success (IOP < 21 mmHg with IOP lowering medication) were 17 operations. As failures (additional surgical procedure required) we considered 19 (16 cyclodestructive procedures, 4 needling procedures, and/or 2 revisions) after in average 7.2 months (0.5-31 months). In relation to all eyes with a follow up of at least six months 19/59 (32%) were failures. Successful outcomes (IOP <21 mmHg without medication) had in average lower IOPs during the first postoperative days (6.6 versus 10.3 mmHg). Temporary peripheral choroidal effusion because of hypotony was noted in 8 eyes. Bleb leakage was detected in 5 eyes.
Conclusions: Nonpenetrating deep sclerectomy is safe but, frequently additional medication or surgical procedures are necessary.

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