Tiefe Sklerektomie mit Hyaluronatimplantat vs. Trabekulektomie

Schwenn, Oliver; Springer, C.; Troost, Annette; Yun, Sung Hyun; Pfeiffer, Norbert

doi:10.1007/s00347-003-0940-x

Cited by 14 publications

(5 citation statements)

References 24 publications

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“…Trabeculectomy significantly reduced IOP in all eyes in our study, similar to other reported data [16,17,18]. Suture removal significantly improved the complete success rate at 12 months from 65 to 94%.…”

Section: Discussionsupporting

confidence: 82%

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Klink¹,

Rauch²,

Klink³

et al. 2008

Ophthalmologica

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Background: To evaluate the influence of early conjunctival suture removal following trabeculectomy on postoperative outcome. Methods: In a prospective randomized clinical trial 73 eyes of 69 consecutive patients eligible for primary trabeculectomy were included in the study. Eyes were randomly assigned to a control or intervention group. Trabeculectomy was performed with a fornix-based conjunctival flap and a conjunctival running mattress-suture. In the intervention group, the conjunctival suture was removed 4 weeks postoperatively, in the control group the suture remained in place. Both groups were followed for up to 12 months and best corrected visual acuity (BCVA), refraction, corneal topography, intraocular pressure (IOP), anterior segment and fundus were assessed preoperatively and within a week, 1, 3, 6 and 12 months after surgery. Statistical analysis was performed using SPSS for Windows (t test for independent samples). Results: Trabeculectomy induced similar astigmatism in both groups. Compared to the control group, suture removal seemed to improve BCVA at 6 and 12 months. This was associated with a significantly lower IOP at 6 and 12 months and a significantly higher complete success rate at 12 months (94 vs. 65%, p < 0.001). Astigmatism was not significantly altered by suture removal. Conclusion: Conjunctival suture material appears to hamper trabeculectomy success and postoperative visual acuity. This is independent of postoperative astigmatism. Early removal of conjunctival sutures is advisable.

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Section: Discussionsupporting

confidence: 82%

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Klink¹,

Rauch²,

Klink³

et al. 2008

Ophthalmologica

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“…A total of 24 articles were excluded, including 9 full reports [16,17,18,19,20,21,22,23,24], and 15 meeting abstracts (see Appendix 1). Out of them, 17 randomized controlled trials were included in the present meta-analysis, 14 published in full form [25,26,27,28,29,30,31,32,33,34,35,36,37,38] and 3 published in abstract form (see Appendix 2). The flowchart of the studies included in our analysis is shown in figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…If the ruptured regions of the juxtacanalicular tissue and canal heal with time, surgery may fail in eyes that did not develop filtration blebs. This problem is soon to be seen in the increasing failure rates of nonpenetrating filtering surgery with time [27, 35]. In an attempt to minimize this healing response, some surgeons have used MMC as an adjunct, and the favorable effect of MMC has been shown [39,40,41].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

Cheng

Wei

et al. 2009

Ophthalmologica

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Aims:To evaluate the efficacy and tolerability of nonpenetrating filtering surgery in the treatment of patients with open-angle glaucoma. Methods: Pertinent studies were selected by extensive searches. A total of 17 randomized controlled trials were included in the present meta-analysis. The main outcome measures were risk differences (RDs) of complete success for efficacy and postoperative complications for tolerability. Pooled estimates were computed according to a random-effects model. Results:Viscocanalostomy and deep sclerectomy were significantly less effective than tra- beculectomy, and pooled RDs of complete success were –0.16 (95% confidence interval, CI, –0.30 to –0.02) and –0.10 (–0.19 to 0.00). Deep sclerectomy plus mitomycin C (MMC) was also less effective than trabeculectomy plus MMC, with pooled RD of complete success being –0.16 (95% CI –0.32 to –0.01). Viscocanalostomy and deep sclerectomy caused main complications in fewer patients than trabeculectomy. Conclusions:Viscocanalostomy and deep sclerectomy were less effective than trabeculectomy in the treatment of open-angle glaucoma, and deep sclerectomy plus MMC was also less effective than trabeculectomy plus MMC. However, viscocanalostomy and deep sclerectomy were associated with fewer complications than trabeculectomy.

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“…Some authors described success rates for similar techniques as standard trabeculectomy in Caucasian patients with open-angle glaucoma [7, 8, 12, 13,28,29,30,31]. Others showed an inferior success rate (defined as an IOP lower than 21 mm Hg without medication) than with standard trabeculectomy [10, 11, 26, 27].…”

Section: Discussionmentioning

confidence: 99%

“…The results are controversial: some studies showed deep sclerectomy as superior [1, 4], others as similar or inferior [7,8,9,10,11,12,13] to standard trabeculectomy in the treatment of open-angle glaucoma. All authors described fewer early postoperative complications using a non-penetrating technique [4,6,7,8, 12, 14]. …”

Section: Introductionmentioning

confidence: 99%

CO<sub>2</sub>, Excimer and Erbium:YAG Laser in Deep Sclerectomy

et al. 2008

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Purpose: Deep sclerectomy is a non-penetrating filtering procedure that is not generally accepted, as tissue dissection is difficult and varying success rates have been reported. The purpose of the present study was to compare the use of CO₂, excimer and erbium:YAG lasers in dissection of the deep corneoscleral lamella. Methods: In enucleated porcine eyes a superficial lamellar scleral flap of 5 × 5 mm was surgically dissected. The deep lamella was removed using a pulsed erbium:YAG, a CO₂ or an excimer laser (10 eyes/group). All eyes were analysed histologically and 3 in each group by scanning electron microscopy (SEM). Results: It is feasible to ablate the deep corneoscleral lamella with the CO₂, excimer and erbium:YAG lasers without perforating the anterior chamber. The following histology and SEM showed a smoother surface after dissection with the CO₂ and excimer lasers compared to the erbium:YAG laser. There was no thermal damage after excimer laser treatment, compared to a damage zone of 10–30 µm using the erbium laser and one of 70–100 µm with the CO₂ laser. Conclusions: Excimer,erbium:YAG and CO₂ lasers allow the microsurgical dissection of the deep lamella. The excimer and CO₂ lasers achieve a more regular and smoother tissue surface. The excimer laser has the advantage to dissect without thermal tissue damage.

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Tiefe Sklerektomie mit Hyaluronatimplantat vs. Trabekulektomie

Cited by 14 publications

References 24 publications

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Influence of Conjunctival Suture Removal on the Outcome of Trabeculectomy

Efficacy and Tolerability of Nonpenetrating Filtering Surgery in the Treatment of Open-Angle Glaucoma: A Meta-Analysis

CO<sub>2</sub>, Excimer and Erbium:YAG Laser in Deep Sclerectomy

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