CO2 Laser-assisted Sclerectomy Surgery, Part II

Abstract

Short-term and intermediate results suggest that CLASS may become a simple, safe, and effective means of choice for the treatment of open-angle glaucoma.

Preliminary results of CO2 laser-assisted sclerectomy surgery (CLASS) in the treatment of advanced glaucoma in a Chinese population

“…[14] In another prospective, nonrandomized, noncomparative, multicenter study, CLASS was conducted in POAG and pseudoexfoliative glaucoma, showing a medication reduction from 2.5 ± 1.3 medications to 0.1 ± 0.4 at 6 months and 0.6 ± 0.9 at 12 months ( P  < 0.001). [11] Similar to our study, the numbers of antiglaucoma eye drops were significantly reduced by 54.3% at 3 months and 38.5% at 6 months. In our study, the IOP reduction was 19.0%, and the medication reduction was 38.2% at 6 months.…”

“…In accordance with other CLASS studies, the reported complications were mostly graded as mild and transitory with no serious postoperative complications. [11] …”

“…[10,11] CO 2 laser-assisted sclerectomy surgery (CLASS) is an enhanced adaptation of manual deep sclerectomy by using a CO 2 laser to ablate the scleral tissue leaving a thin membrane just enough for aqueous seepage, but without entering the anterior chamber since the laser energy is absorbed once there is seepage of aqueous.…”

CO2 laser‐assisted sclerectomy surgery compared with trabeculectomy in primary open‐angle glaucoma and exfoliative glaucoma. A 1‐year follow‐up

“…CO 2 laser-assisted sclerectomy surgery (CLASS) was performed in the superior quadrant, following the technique described by Geffen et al (2012), using a commercially available OT-135 CO 2 laser system (IOPtiMate; IOPtima Ltd, Ramat Gan, Israel). The procedure involved a corneal traction suture, conjunctival peritomy, opening and dissection of the Tenon's capsule, cauterization of bleeding vessels within the area of exposed sclera and dissection of 50% lamellar scleral flap of dimensions 4 mm 9 4 mm at the 12-o'clock position using a feather blade (initial horizontal incision) and a crescent blade (flap dissection).…”

Glaucoma: Present Challenges and Future Trends

“…Presently, only 1 pilot study of CLASS has been published, on 37 patients, most of whom were also exposed to MMC intraoperatively. Complete success at 6 and 12 months was not outstanding, attaining only 76.7 and 60%, respectively, but no major complications ensued, and this aspect can be valuable in skipping the learning curve that otherwise affects incisional NPGSs [89]. …”