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Nonpenetrating deep sclerectomy versus trabeculectomy in bilateral primary open-angle glaucoma.
F El Sayyad1, M Helal, H El-Kholify
1El-Maghraby Eye Hospital, Jeddah, Saudi Arabia.
Ophthalmology
|August 31, 2000
Summary
Nonpenetrating deep sclerectomy and trabeculectomy show similar efficacy for primary open-angle glaucoma. Deep sclerectomy may offer a safer alternative with fewer complications.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
Background:
- Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
- Effective surgical management is crucial for lowering intraocular pressure (IOP) and preventing optic nerve damage.
Purpose of the Study:
- To compare the efficacy and safety of nonpenetrating deep sclerectomy (NPDS) versus trabeculectomy in patients with POAG.
Main Methods:
- A prospective randomized trial involving 39 patients with bilateral POAG.
- Each patient underwent NPDS in one eye and trabeculectomy in the fellow eye.
- Outcomes assessed included mean IOP, postoperative medications, visual acuity, success rate, and complications.
Main Results:
- At 12 months, both NPDS and trabeculectomy achieved significant IOP reduction (12.3 vs. 14.1 mmHg, P=0.15).
- High success rates were observed for both procedures (92.3% for NPDS, 94.9% for trabeculectomy).
- Trabeculectomy was associated with flat/shallow anterior chambers and hypotony, while NPDS had a higher incidence of iris incarceration.
Conclusions:
- NPDS demonstrates comparable IOP-lowering efficacy to trabeculectomy in POAG management.
- NPDS may be associated with a potentially better safety profile, with fewer sight-threatening complications.