Deep sclerectomy with collagen implant: medium term results.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Innovation

Background:

• Open-angle glaucoma requires effective intraocular pressure (IOP) management to prevent optic nerve damage.
• Non-penetrating glaucoma surgeries are explored as alternatives to traditional filtering procedures.
• Deep sclerectomy with collagen implant (DSCI) is a novel surgical technique.

Purpose of the Study:

• To prospectively evaluate the efficacy and safety of deep sclerectomy with collagen implant (DSCI).
• To determine the success rate and complication profile of DSCI in patients with medically uncontrolled open-angle glaucoma.

Main Methods:

• A prospective, non-randomized trial included 100 eyes of 100 patients with open-angle glaucoma.
• The DSCI procedure involved raising a superficial scleral flap, performing deep sclerectomy, opening Schlemm's canal, and implanting collagen.
• Intraocular pressure (IOP) and visual acuity were monitored for up to 36 months.

Main Results:

• Mean follow-up was 17.8 months. Preoperative mean IOP was 27.8 mm Hg, reducing to 13.0 mm Hg at 36 months.
• Complete success (IOP < 21 mm Hg without medication) was 44.6% at 36 months; qualified success (IOP < 21 mm Hg with medication) was 97.7%.
• Early complications included hyphaema, wound leak, and choroidal detachment. Subsequent interventions like goniopuncture and 5-FU injections were needed in some cases.

Conclusions:

• Deep sclerectomy with collagen implant provides reasonable IOP control in open-angle glaucoma patients.
• The DSCI procedure demonstrates a favorable safety profile with few immediate postoperative complications.
• DSCI is a viable option for managing medically uncontrolled open-angle glaucoma at medium-term follow-up.