The efficacy of modified non-penetrating deep sclerectomy in open-angle glaucoma treatment
https://doi.org/10.18008/1816-5095-2015-1-57-62
Abstract
Aim. To analyze the efficacy of modified non-penetrating deep sclerectomy.
Materials and methods. POAG patients enrolled in the study were divided into 2 groups: study group included 29 patients who were referred for modified non-penetrating deep sclerectomy, control group included 33 patients who were referred for standard non-penetrating deep sclerectomy. IOP level was 31.9±3.2 mm Hg in the study group and 31.5±3.3 mm Hg in the control group. Modification of non-penetrating deep sclerectomy consists in the separation of fornix-based Ushaped scleral flap, Schlemm’s canal opening, scleral tunnel creation and its dilation with polyamide 5/0 suture.
Results. Three weeks after surgery, moderate hypotension was observed in both groups (15.7±1.56 mm Hg in the study group and 16.9±1.9 in the control group). Three months after surgery, IOP level was 17.47±1.24 mm Hg in the study group and 18.74±1.37 in the control group. Ten months after surgery, IOP level in the study group was significantly lower than in the control group (19.14±1.27 mm Hg and 21.31±1.42 mm Hg, respectively, р<0.05).
Conclusions. The proposed surgical technique provides stable and long-term hypotensive effect and prevents excessive scarring in filtering area. Suture inserted into the scleral tunnel dilates it and provides continuous aqueous humor outflow.
About the Author
E. A. Ivachev
Penza Regional Ophthalmic Hospital, 32, Krasnaya Str. Penza, Russia, 440026
Russian Federation
Russian Federation
References
1. Libman E. S. [Epidemiological characteristics of glaucoma]. Epidemiologicheskaya kharakteristika glaukomy. [Glaucoma]. Glaukoma. 2009; 1: 2-3. (in Russ.).
2. Kurysheva N. I., Brezhnev A. Yu., Kapkova S. G. [The prevalence of pseudoexfoliative glaucoma in the Central and Central-Chernozem regions of Russia]. Rasprostranennost’ psevdoeksfoliativnoy glaukomy v Tsentral’nom i Tsentral’no-Chernozemnom regionakh Rossii. [Glaucoma]. Glaukoma. 2008; 3: 11-15. (in Russ.).
3. Quigley H.A., Broman A.T. The number of people with glaucoma worldwide in 2010 and 2020. Br. J. Ophthalmol. 2006; 90: 262-267.
4. Neroev V. V., Bykov V. P., Kvasha O. I., Belevtseva T. A. [The outcomes of novel micro drainage surgery]. Rezul’taty novogo metoda mikrodrenirovaniya v eksperimente. [Russian Ophthalmological Journal]. Rossiyskiy oftal’mologicheskiy zhurnal. 2011; 4 (2): 78-81. (in Russ.).
5. Arsyutov D. G., Skvortsov V. V., Pashtaev N. P. [Scleral sinus inner wall in activation of aqueous humor outflow during glaucoma surgery]. Ispol’zovanie vnutrenney stenki skleral’nogo sinusa v khode antiglaukomnykh operatsiy dlya aktivatsii ottoka vnutriglaznoy zhidkosti. [Clinical Ophthalmology]. Klinicheskaya oftal’mologiya. 2008; 4: 153-155. (in Russ.).
6. Kiseleva O. A., Filippova O. M., Bessmertnyy A. M., Kalinina O. M., Balakireva E. V. [I-Gen implant prolongs hypotensive effect of glaucoma surgery]. Implantat IGen — prolongatsiya gipotenzivnoy effektivnosti khirurgii glaukomy. [Russian Ophthalmological Journal]. Rossiyskiy oftal’mologicheskiy zhurnal. 2012; 1: 37-41. (in Russ.).
7. Cheng A. C., Yuen K. S., Lai J. S. The Ahmed glaucoma valve in refractory glaucoma: experiences in Indian eyes. Eye. 2006; 20 (7): 848-849.
8. Cillino S., Di Pace F., Casuccio A., Lodato G. Deep sclerectomy versus punch trabeculectomy: effect of low-dosage mitomycin C. Ophthalmology. 2005; 219: 281-286.
9. Ollikainen M. L., Puustjärvi T. J., Rekonen P. K., Uusitalo H. M., Teräsvirta M. E. Mitomycin C-augmented deep sclerectomy in primary open-angle glaucoma and exfoliation glaucoma: a three-year prospective study. Acta Ophthalmologica. 2011; 89: 548-555.
10. Takhchidi Kh.P., Ivanov D.I., Bardasov D.B. [Long-term outcomes of microinvasive non-penetrating deep sclerectomy]. Otdalennye rezul’taty mikroinvazivnoy nepronikayushchey glubokoy sklerektomii. [Ophthalmosurgery]. Oftal’mokhirurgiya. 2003; 3: 14-17. (in Russ.).
11. Lebedev O. I., Yavorskiy A. V., Stolyarov G. M., Molchanova E. V., Kovalevskiy V. V. [Prevention of excessive scarring in non-penetrating deep sclerectomy]. Profilaktika izbytochnogo rubtsevaniya pri nepronikayushchey glubokoy sklerektomii [Glaucoma]. Glaukoma. 2011; 1: 32-36. (in Russ.).
12. Bakunina N. A., Fedorov A. A., Kolesnikova L. N. [A method of excessive scarring prevention following non-penetrating deep sclerectomy]. Sposob umen’sheniya formirovaniya rubtsovoy tkani posle nepronikayushchey glubokoy sklerektomii. [Glaucoma]. Glaukoma. 2009; 1: 3-6. (in Russ.).
13. Shmyreva V.F., Petrov S.Yu., Makarova A.S. [Causes of glaucoma surgery efficacy decrease in the late post-op period and the methods of its enhancement]. Prichiny snizheniya otdalennoy gipotenzivnoy effektivnosti antiglaukomatoznykh operatsiy i vozmozhnosti ee povysheniya. [Glaucoma]. Glaukoma. 2010: 2: 43-49. (in Russ.).
14. Nesterov A.P. [Primary glaucoma]. Pervichnaya glaukoma. Moscow, Medicina, 1982. (in Russ.).
Review
For citations:
Ivachev E.A. The efficacy of modified non-penetrating deep sclerectomy in open-angle glaucoma treatment. Ophthalmology in Russia. 2015;12(1):57-62. (In Russ.) https://doi.org/10.18008/1816-5095-2015-1-57-62
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