Comparative Study between Non Penetrating Glaucoma Surgery with and without Implant

Abstract

Objective: Analysis of safety and efficacy of Self engineered polymethylmethacrylate (Acry C) implants in Non-Penetrating Glaucoma surgery (NPGS) as compared to NPGS without implants for control and maintenance of Intraocular pressure in Primary Open Angle Glaucoma (POAG) patients. Design: A Hospital based Randomized study Participants: 70 eyes of 70 POAG patients, divided in 2 groups based on whether implants were used in NPGS Materials: NPGS was done in 35 patients with poly-methyl methacrylate implants made from haptics of intraocular lenses and without the implant in the remaining 35. All patients were followed up after 1 week, 1 month, 3 months, 6 months and 12 months. Post-operative success was defined as IOP <21 mm Hg at 1 month in absence of additional anti glaucoma medication or other treatment. Results: A significant reduction in intraocular pressure was observed post-surgery in both groups, changing from a preoperative mean of 31.09±7.37 mm of Hg and 29.26 ±7.10 mm of Hg to a postoperative mean of 15 ±3.06 mm of Hg and 14.85 ±4.22 mm of Hg respectively (P<0.001) at 12 months. It was observed that intraocular pressure was significantly controlled in both groups and that between two groups the difference was insignificant. It was however seen that Failure rates were higher with NPGS without implant as compared to with implant (p<0.05). For both procedures, the only significant complication was failure of surgery. Conclusion: NPGS with Acry -C implants is a safe, noninvasive and cost effective (less than one U.S. dollar) procedure for control of Intraocular pressure in POAG patients and results in lower failure rates as compared to NPGS without implants and should therefore be preferred as the first line surgical treatment in Primary Open Angle Glaucoma.