Aims: A pilot study of the safety and efficacy of deep sclerectomy with a chromic suture implant (DSCI) for open angle glaucoma. Methods: This prospective trial involved 23 eyes of 16 consecutive patients with uncontr...Aims: A pilot study of the safety and efficacy of deep sclerectomy with a chromic suture implant (DSCI) for open angle glaucoma. Methods: This prospective trial involved 23 eyes of 16 consecutive patients with uncontrolled open angle glaucoma. The DSCI procedure involved radial suturing of a 2mm piece of 1/0 chromic suture as an implant. Intraocular pressure (IOP) measurements and eye examinations were performed preoperatively and regularly postoperatively for up to 66 months. Results: The mean follow-up period was 36.3 (SD 19.9)-months. The mean preoperative IOPwas 26.3 (SD 8.5)mmHg. Themean postoperative IOPwas 14.1 (SD 2.8)mmHg atmonth 12, and 16.5 (SD 2.3)mmHg at 36 months. Complete success rate, defined as an IOPlower than 21mmHg without medication was 77%of eyes at 36 months. Qualified success rate, defined as an IOPl ower than 21mmHg with medication, was 100%at 36 months. Paired t-test andWilcoxon test analysis of preoperative vs postoperative IOPat 36 months indicated a significant reduction in IOP, Intraoperative complications included rupture of the trabecular meshwork in seven eyes. Exclusion of these patients from the results analysis revealed a mean follow-up of 37.1 months (SD 9), preoperative mean IOPwas 25.9mmHg (SD 4.1), 12-month mean IOPwas 13.4mmHg (SD 2.8), and 36-month mean IOP16.6mmHg (SD 2.1). Early postoperative complications included hyphaema in two eyes and dislocation of implant in one eye. One eye developed a central retinal vein occlusion and cataract progression occurred in one eye. The mean postoperative duration of use of topical dexamethasone was 5.4 months (SD 2). Conclusions: DSCI using a chromic suture implant provides good control of IOPat medium-term follow-upwith fewpostoperative complications. Prolonged use of postoperative anti-inflammatory medication was necessary.展开更多
文摘Aims: A pilot study of the safety and efficacy of deep sclerectomy with a chromic suture implant (DSCI) for open angle glaucoma. Methods: This prospective trial involved 23 eyes of 16 consecutive patients with uncontrolled open angle glaucoma. The DSCI procedure involved radial suturing of a 2mm piece of 1/0 chromic suture as an implant. Intraocular pressure (IOP) measurements and eye examinations were performed preoperatively and regularly postoperatively for up to 66 months. Results: The mean follow-up period was 36.3 (SD 19.9)-months. The mean preoperative IOPwas 26.3 (SD 8.5)mmHg. Themean postoperative IOPwas 14.1 (SD 2.8)mmHg atmonth 12, and 16.5 (SD 2.3)mmHg at 36 months. Complete success rate, defined as an IOPlower than 21mmHg without medication was 77%of eyes at 36 months. Qualified success rate, defined as an IOPl ower than 21mmHg with medication, was 100%at 36 months. Paired t-test andWilcoxon test analysis of preoperative vs postoperative IOPat 36 months indicated a significant reduction in IOP, Intraoperative complications included rupture of the trabecular meshwork in seven eyes. Exclusion of these patients from the results analysis revealed a mean follow-up of 37.1 months (SD 9), preoperative mean IOPwas 25.9mmHg (SD 4.1), 12-month mean IOPwas 13.4mmHg (SD 2.8), and 36-month mean IOP16.6mmHg (SD 2.1). Early postoperative complications included hyphaema in two eyes and dislocation of implant in one eye. One eye developed a central retinal vein occlusion and cataract progression occurred in one eye. The mean postoperative duration of use of topical dexamethasone was 5.4 months (SD 2). Conclusions: DSCI using a chromic suture implant provides good control of IOPat medium-term follow-upwith fewpostoperative complications. Prolonged use of postoperative anti-inflammatory medication was necessary.
