Viscocanalostomy versus trabeculectomy in white adults affected by open-angle glaucoma

Carassa, Roberto; Bettin, Paolo; Fiori, Marina; Brancato, Rosario

doi:10.1016/s0161-6420(03)00081-2

Cited by 137 publications

(89 citation statements)

References 10 publications

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“…The reduction of IOP in NPT may be similar or less than the one achieved with standard trabeculectomy. [16][17][18][19][20][21][22] Deep sclerectomy may lead to a reduction of IOP via a number of possible mechanisms, 1 which might include: creation of a subconjunctival filtering bleb, removal of juxtacanalicular tissue, where it is thought the majority of the flow resistance is located, filtration to the supraciliary/suprachoroidal space, vaulting of residual trabecular meshwork toward the intrascleral cavity leading to widening of the cribriform interspace (similar to laser trabeculoplasty), and development of new aqueous drainage veins in the scleral space, months after deep sclerectomy. [23][24][25] UBM can be used to evaluate the morphology and changes of the residual tissue after glaucoma surgery.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound biomicroscopy in deep sclerectomy

Khairy

Atta

Green

et al. 2005

Eye

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Purpose To evaluate by ultrasound biomicroscopy (UBM) the anatomical characteristics and the intraocular pressure (IOP) lowering mechanisms of deep sclerectomy after long-term follow-up. Methods In all, 22 eyes of 21 consecutive patients who had deep sclerectomy were examined by UBM. Several UBM variables were prospectively evaluated, including the presence and maximum length and height of the intrascleral space, the minimum thickness of residual trabeculo-Descemet membrane (TDM), the presence and type of subconjunctival filtering bleb, and the presence of other possible drainage sites, for example suprachoroidal. Surgical success was considered to be achieved when the IOP was o22 mmHg and the IOP was lowered by more than 20% without the use of any medication. The possible association between UBM variables and the surgical outcome was determined. Results The mean time between surgery and the UBM examination was 12.075.3 months. The mean IOP decreased significantly from a preoperative value of 23.774.0 to 16.073.9 mmHg at the time of UBM (Po0.01). There was a poor correlation between the level of IOP at the time of UBM and the length of intrascleral space (r 2 ¼ 0.0016), the height of the intrascleral space (r 2 ¼ 0.136), or the thickness of remaining TDM (r 2 ¼ 0.0009). The presence and type of filtering bleb were not associated with the success. Conclusions In patients undergoing deep sclerectomy, UBM examination after long-term follow-up showed the presence of an intrascleral space and a filtering bleb in most patients. The surgical outcome was not associated with the UBM variables of the surgical area.

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Section: Discussionmentioning

confidence: 99%

Ultrasound biomicroscopy in deep sclerectomy

Khairy

Atta

Green

et al. 2005

Eye

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“…In recent years several alternative procedures have been evaluated and compared to trabeculectomy. [1][2][3][4][5] The Ex-PRESS glaucoma filtration device (Alcon Laboratories, Fort Worth, TX, USA) was developed as an alternative to trabeculectomy, and shows similar IOP reduction with fewer complications. Its original design required insertion under a conjunctival flap through the full scleral thickness.…”

Section: Introductionmentioning

confidence: 99%

Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study

Dahan

Simon

Lafuma

2012

Eye

100

117

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“…2 The comparative efficacy of the various types of NPGS to trabeculectomy remains a subject of some debate but most reports agree that NPGS has a lower rate of complications than trabeculectomy. [10][11][12][13][14][15] DS has been shown to be equivalent to trabeculectomy in lowering the intraocular pressure (IOP) in some recent publications. 11,16,17 Excellent long-term results have been reported with DS as the primary surgery for open-angle glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Anand

Wechsler²

2011

Eye

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Purpose To report outcomes of deep sclerectomy (DS) with intraoperative mitomycin C (MMC) application in eyes with previous failed glaucoma surgery (GS) and/or cataract extraction (CE). Patients and methods Single-surgeon case series of 82 eyes of 82 patients undergoing DS with MMC. The patients had previous CE with IOL and/or conjunctival GS and treated intraocular pressure (IOP) 418 mm Hg. MMC (0.2 mg/ml) was applied for 2-3 min before scleral flap dissection. Complete success was defined as IOP between 6 and 21 mm Hg or a reduction of 20% from baseline without medications. Reoperation for glaucoma or related complications, or loss of light perception vision was considered as failure. Results Mean follow-up was 57.7±22.4 months with 78% of patients completing the 3-year follow-up. Mean IOP decreased from 24.0 mm Hg (22.3-25.6, 95% confidence intervals) to 13.4 mm Hg (12.0-14.2) at 3 years after surgery (Po0.001). There was a significant decrease in the number of glaucoma medications from 2.0±1 preoperatively, to 0.3±0.7, 3 years after surgery. Kaplan-Meier cumulative success rates were 85.6% at 1 year, 80.0% at 2 years, and 76% at 3 years. At 3 years, IOP was maintained o19 and 15 mm Hg in 83 and 70% of eyes, respectively. Fourteen eyes (17.1%) had complications. Delayed hypotony (IOP o6 mm Hg) was the commonest complication in five eyes (6.1%). Conclusion DS with MMC appears to be a safe and effective surgical procedure for eyes with previous intraocular surgery.

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Viscocanalostomy versus trabeculectomy in white adults affected by open-angle glaucoma

Cited by 137 publications

References 10 publications

Ultrasound biomicroscopy in deep sclerectomy

Ultrasound biomicroscopy in deep sclerectomy

Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

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