[Sclerothalamectomy (STE): stable postoperative intraocular pressure regulation in primary open-angle and...

Since the 70th years we operated the hemorrhagic glaucoma by a ciliary body exposure after Benedikt. In a few patients we noted a stable intraocular pressure regulation for years, often in these cases where there is no filtering bleb. This signifies, that the ciliary body is heavily involved in the resorption of the anterior chamber fluid. During the following next years we further developed this operating technique and we use it today successfully in the operative treatment of primary open angle- and pseudoexfoliative glaucoma.

Since march 1996 we performed a sclerothalamectomy in 46 eyes. In approximate the half of cases the operation was done combined with a cataract surgery. 27 eyes had a primary open angle and 19 eyes a pseudoexfoliative glaucoma with a mean preoperative intra-ocular pressure of 29.79 +/- 7.96 mm Hg respectively of 33.58 +/- 9.32 mm Hg.

The mean follow-up was in the case of primary open angle glaucoma 18.3 +/- 8.9 (median 20) and in the case of pseudoexfoliative glaucoma 15.8 +/- 11 (median 16) months. The mean postoperative intra-ocular pressure, which range in the group of primary open angle glaucoma 13.9 +/- 1.6 mm Hg and in the group of pseudoexfoliative glaucoma 12.9 +/- 2.5 mm Hg, was significant lower with significant less postoperative medication compared with the preoperative values during the complete follow-up (p < 0.01). There was no evidence in a significant difference between the both groups regarding the postoperative complication rate and intra-ocular pressure. We observed altogether in 7 eyes a flat filtering bleb, 5/27 in the primary open angle glaucoma and 2/19 in the pseudoexfoliative glaucoma group. In all of other cases we didn't state a filtering bleb.

The sclerothalamectomy leeds to a long-term stable intra-ocular pressure with a contemporary low complication rate in the case of primary open angle- and pseudoexfoliative glaucoma.