Modified deep sclerectomy for the surgical treatment of glaucoma

Sharifipour, Farideh; Yazdani, Shahin; Asadi, Mona; Saki, Azadeh; Nouri‐Mahdavi, Kouros

doi:10.4103/jovr.jovr_228_17

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…They found similar IOP reductions with MDS as of with trabeculectomy. [10] In our technique, we have combined trabeculectomy with a limited deep sclerectomy and have used the excised scleral tissue block as a spacer to keep the cyclodialysis cleft open, preventing closure and fibrosis. The deep sclerectomy also creates a scleral lake to augment the drainage along with trabeculectomy and cyclodialysis.…”

Section: Discussionmentioning

confidence: 99%

Trabeculectomy Augmented with Limited Deep Sclerectomy and Cyclodialysis with Use of Scleral Tissue as a Spacer

Dada

Shakrawal

Ramesh

et al. 2022

JOVR

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Trabeculectomy remains the most commonly performed surgery for medically uncontrolled glaucoma. Its success in primary open angle glaucoma is approximately 82% in the initial year after surgery and 64% at the end of five years. Lower success rates have been found in secondary glaucomas like neovascular glucoma, uvietic glaucoma, post-traumatic glaucoma, and for repeat surgeries. To illustrate improvement of the efficacy of trabeculectomy, enhancement with cyclodialysis has been introduced. This involves the creation of a cyclodialysis cleft in a controlled manner to allow additional suprachoroidal drainage of the aqueous. Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an additional pathway for aqueous humor drainage. However, such a cleft often closes on its own due to associated inflammation caused by the filtration surgery. Deep sclerectomy is a non-penetrating surgery that involves dissection of a scleral patch and excision of a block of scleral tissue, retaining a thin membrane for aqueous drainage. In this study, we introduce a novel surgical technique of combining trabeculectomy with a limited deep sclerectomy and a cyclodialysis in two pseudophakic patients who developed secondary glaucoma after vitreo-retinal surgery with silicone oil insertion. In this technique the excised scleral tissue obtained after deep sclerectomy was utilized as a spacer to maintain the patency of the cyclodialysis cleft.

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Section: Discussionmentioning

confidence: 99%

Trabeculectomy Augmented with Limited Deep Sclerectomy and Cyclodialysis with Use of Scleral Tissue as a Spacer

Dada

Shakrawal

Ramesh

et al. 2022

JOVR

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“…Studies have shown that deep sclerectomy is inferior to trabeculectomy but modifications in this technique can provide favourable results 20 .…”

Section: Discussionmentioning

confidence: 99%

Deep Sclerectomy with Low-Tension Sutures versus Tight-Tension Sutures without Space-Maintaining Implant in Controlling Intraocular Pressures

Zia¹,

Jain²,

Dardzhikova³

2020

pak J Ophthalmol

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Purpose: To compare the IOP lowering effect and post-operative complications of low tension sutures versus tight tension sutures in deep sclerectomy. Study Design: Quasi experimental study. Place and Duration of Study: Methods: Twenty seven eyes undergoing deep sclerectomy operation with normal strength sutures (TS) were compared with 21 eyes undergoing a modified technique in which low tension sutureswere tied to only approximate anatomy (LS). Both sets of patients were operated on by the same experienced surgeon with similar technique except for the tensile strength of suture; same antimetabolite in similar concentration was used with identical pre and post-operative care. Outcome measures were post-operative intraocular pressure, number of medications needed and complications. Results: IOP decreased significantly in both groups, in TS group by 12.6 mm Hg (p < 0.001) and in the LS groups by 18.9mm Hg (p < 0.001). Greater IOP drop was seen in LS group versus TS group (p = 0.046). In LS group number of eye drops required post operatively were significantly less than TS group (p = 0.007). After follow up only one patient in the loose suture group still required IOP-lowering medication. There were minimal complications in both groups, 1 patient in the LS group and 7 in TS group required a YAG Goniotomy. Conclusion: Using low tension sutures in deep sclerectomy increases the IOP lowering effect of the surgery and reduces the number of medications the patient requires post operatively.

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Modified deep sclerectomy for the surgical treatment of glaucoma

Cited by 2 publications

References 27 publications

Trabeculectomy Augmented with Limited Deep Sclerectomy and Cyclodialysis with Use of Scleral Tissue as a Spacer

Trabeculectomy Augmented with Limited Deep Sclerectomy and Cyclodialysis with Use of Scleral Tissue as a Spacer

Deep Sclerectomy with Low-Tension Sutures versus Tight-Tension Sutures without Space-Maintaining Implant in Controlling Intraocular Pressures

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