Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
DOI:
https://doi.org/10.48560/rspo.25711Keywords:
Filtering Surgery, Glaucoma, Intraocular Pressure, SclerostomyAbstract
INTRODUCTION: Deep sclerectomy is a nonpenetrating glaucoma surgery that presents as an effective option for open angle glaucoma treatment, with an enhanced safety profile than trabeculectomy. In this study, we present the long-term outcomes of deep sclerectomy in open angle glaucoma patients.
METHODS: Retrospective analysis of patients with open angle glaucoma submitted to nonpenetrating deep sclerectomy (NPDS) between 2011 and 2017, at Hospital Pedro Hispano. A minimum of 2 years of follow-up was required. Absolute success was defined as postoperative intraocular pressure (IOP) ≤18 mmHg without additional treatment and qualified success as post- operative IOP ≤18 mmHg with or without additional treatment.
RESULTS: A total of 76 eyes with primary open angle glaucoma (56 eyes, 73.7%) or pseudo-exfoliative glaucoma (20 eyes, 26.3%) were included in this study. IOP was significantly reduced after surgery (p<0.001), with mean IOP<18 mmHg in all the evaluated follow-up moments (until month 84). Therapeutic success was superior to 90% in in the first 24 months. Absolute success was achieved in 78.4%, 60.7% and 51.2% at 24, 36 and 60 months of follow-up. Qualified success was achieved in 91.6%, 86.9% and 90.2% (24, 36 and 60 months). Additional treatment was re- quired in 33 eyes (43.4%). Postoperatively, the mean number of medications dropped from 2.4 to 0.8 (p<0.05). Postoperative complications were infrequent.
CONCLUSION: Nonpenetrating deep sclerectomy is a safe and effective surgical procedure in open angle glaucoma, allowing sustained IOP control over time, allied to a low rate of surgical complications.
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