98th Annual Meeting DOG 2000

K 51

Deep sclerectomy: Results and complications

M. Yamin, C. D. Quentin

The deep sclerectomy as non perforating glaucoma surgery seems to offer the advantage of less complications during the first weeks after surgery than the classic trabeculectomy. Till yet it is uncertain, if the effect of intra-ocular pressure control after deep sclerectomy is as good as after the trabeculectomy.

Patients and Method: In this prospectiv study 63 eyes of 50 patients had a deep sclerectomy. The age of the patients was between 6 months and 91 years (mean 70.3 yrs.). The mean follow up was 9.6 months (6 to 18 mon.) 16 eyes had glaucoma surgery previously wherefore 7 eyes were treated additionally intraoperatively with Mitomycin C. A combined cataract –deep sclerectomy had 8 eyes. The deep sclerectomy was performed without injecting material of high viscosity into Schlemm’ canal or using a collagen implant.

Results: The mean preoperative pressure was 25.03 (+/-9.3) mmHg and postoperative 12.03 (+/-4.1) mmHg. The number of glaucoma medications was reduced from 2.7 to 1.9 substances and the number of eye drops could be lowered from 5.0 (+/-2.9) to 0.64 (+/-1.4). Complications were a temporary hyphema (n=4), a flat, but very large filtration bleb (n=3) and delayed pressure reduction (n=2). 40% of eyes needed glaucoma medication again but less than before surgery. Mostly during the first three months the local medication had to be introduced again.

Conclusion: The deep sclerectomy as non penetrating glaucoma surgery lowers the intraocular presure as good as the standard trabeculectomy. Its complication rate is very low during the early postoperative weeks. The number of patients who still need glaucoma medication after three months (40%) seems to be higher as after trabeculectomy.

Augenklinik, Georg-August-Universität Göttingen, Robert-Koch-Straße 40, D – 37075 Göttingen