Non-penetrating deep sclerectomy (NPDS) with or without collagen device (CD) in primary open-angle glaucoma: middle-term retrospective study

Demailly, P; Lavat, P; Kretz, G; Jeanteur-Lunel, M.N.

doi:10.1007/bf00212959

Cited by 88 publications

(106 citation statements)

References 2 publications

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“…Several authors reported a favourable outcome after DSCI. 8,11,15,16 However, Demailly et al 17 concluded that collagen devices did not seem to improve tonometric results after mid-term follow-up. Mitomycin-C (MMC) and 5-FU are commonly used in high-risk filtration surgeries to improve the surgical success rate in these patients.…”

Section: -14mentioning

confidence: 99%

“…In many published series postoperative goniopuncture is performed with a Nd : YAG laser which transform a nonpenetrating operation to a penetrating one. [15][16][17][18][19][20][21] A few prospective studies comparing standard trabeculectomy and NPT have been published. In prospective randomised clinical trials El-Sayyad et al 3 and Lachkar et al 22 randomly assigned patients to receive deep sclerectomy in one eye and trabeculectomy on the other eye.…”

Section: -14mentioning

confidence: 99%

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Control of intraocular pressure after deep sclerectomy

Khairy

Green

Nassar

et al. 2005

Eye

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Aim To study the long-term outcome of deep sclerectomy in patients with open angle glaucoma. Methods Prospective consecutive series of 43 eyes (38 patients) with medically uncontrolled open-angle glaucoma undergoing deep sclerectomy. All patients underwent clinical assessment before and after surgery at day 7 and at months 1, 3,6,12,18,24, 36. Surgical success was considered if the patient's intraocular pressure (IOP)o22 mmHg and the IOP was lowered by more than 20% without the use of any medication. Kaplan-Meier survival curves were used to evaluate the success rate. Results The mean follow-up time was 28.178.2 months. Mean IOP decreased significantly from a preoperative value of 24.675.5 mmHg to a postoperative value of 18.574.6 mmHg at 36 months (Po0.001). Microperforation of TDM occurred in three cases (7.0%) and ciliary body prolapse in one case (2.3%) but did not prevent completion of the operation. Postoperatively, hyphaema was detected in one case and shallow anterior chamber in another case and both were treated conservatively. Bleb encapsulation with elevation of IOP occurred in two cases (4.7%) and was treated with 5-fluorouracil subconjunctival injection. Goniopuncture with neodymium : YAG laser was performed in two cases (4.7%). There were no other late complications with the exception of failure of the operation. On the life-table analysis the success rate at 12, 24, and 30 months were 61.4, 36.6, and 18.9%, respectively. Conclusion Deep sclerectomy reduced the IOP temporarily while minimising the risk of postoperative complications commonly encountered with standard trabeculectomy. However, after long-term follow-up surgery failed to maintain a low IOP.

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Section: -14mentioning

confidence: 99%

Section: -14mentioning

confidence: 99%

Control of intraocular pressure after deep sclerectomy

Khairy

Green

Nassar

et al. 2005

Eye

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“…Kozlov, Fyodorov, Mermoud, Demailly, and others have published excellent results using this implant. [6][7][8][9][10] The success rate of DSCI with the AquaFlow TM is comparable to trabeculectomy. 20, 21 Mermoud and co-workers and El Sayyad and co-workers found a similar success rate to trabeculectomy using the AquaFlow TM implant.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] In 1989, Fyodorov, Kozlov and colleagues described a nonpenetrating deep sclerectomy procedure with implantation of a collagen drainage device. The Aqua-Flow TM collagen drainage device (STAAR Surgical Company) is placed under a scleral flap and facilitates the flow of aqueous humour out of the eye to form a bleb under the conjunctiva.…”

Section: Introductionmentioning

confidence: 99%

“…Demailly, Karlen and others have published medium-to long-term results of this procedure, which is successful in lowering intraocular pressure (IOP) and is reported to have a lower rate of postoperative complications than standard trabeculectomy. [7][8][9][10][11][12] There is a lower risk of postoperative inflammation and shallow anterior chambers. However, the surgical technique is more difficult than standard trabeculectomy and the implant is expensive.…”

Section: Introductionmentioning

confidence: 99%

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A pilot study of deep sclerectomy with implantation of chromic suture material as a collagen implant: medium-term results

Wevill

Meyer

Aswegen

2004

Eye

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Aims A pilot study of the safety and efficacy of deep sclerectomy with a chromic suture implant (DSCI) for open angle glaucoma. Methods This prospective trial involved 23 eyes of 16 consecutive patients with uncontrolled open angle glaucoma. The DSCI procedure involved radial suturing of a 2 mm piece of 1/0 chromic suture as an implant. Intraocular pressure (IOP) measurements and eye examinations were performed preoperatively and regularly postoperatively for up to 66 months. Results The mean follow-up period was 36.3 (SD 19.9) months. The mean preoperative IOP was 26.3 (SD 8.5) mmHg. The mean postoperative IOP was 14.1 (SD 2.8) mmHg at month 12, and 16.5 (SD 2.3) mmHg at 36 months. Complete success rate, defined as an IOP lower than 21 mmHg without medication was 77% of eyes at 36 months. Qualified success rate, defined as an IOP lower than 21 mmHg with medication, was 100% at 36 months. Paired t-test and Wilcoxon test analysis of preoperative vs postoperative IOP at 36 months indicated a significant reduction in IOP. Intraoperative complications included rupture of the trabecular meshwork in seven eyes. Exclusion of these patients from the results analysis revealed a mean follow-up of 37.1 months (SD 9), preoperative mean IOP was 25.9 mmHg (SD 4.1), 12-month mean IOP was 13.4 mmHg (SD 2.8), and 36-month mean IOP 16.6 mmHg (SD 2.1). Early postoperative complications included hyphaema in two eyes and dislocation of implant in one eye. One eye developed a central retinal vein occlusion and cataract progression occurred in one eye.The mean postoperative duration of use of topical dexamethasone was 5.4 months (SD 2). Conclusions DSCI using a chromic suture implant provides good control of IOP at medium-term follow-up with few postoperative complications. Prolonged use of postoperative anti-inflammatory medication was necessary.

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