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Enzymatic sclerostomy: pilot human study.

Jacob A Dan1, Santosh G Honavar, David A Belyea

  • 1PO Box 38, Hod-Hasharon 45100, Israel. jdan@netvision.net.il

Archives of Ophthalmology (Chicago, Ill. : 1960)
|May 25, 2002
PubMed
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Enzymatic sclerostomy effectively lowered intraocular pressure in patients with open-angle glaucoma, offering symptomatic relief. Further technical improvements are needed for this novel glaucoma treatment.

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Innovation

Background:

  • Open-angle glaucoma is a leading cause of irreversible blindness.
  • Current treatments aim to reduce intraocular pressure (IOP) but can have limitations.
  • Novel surgical approaches are needed to improve IOP management.

Purpose of the Study:

  • To assess the feasibility and safety of enzymatic sclerostomy for lowering IOP.
  • To evaluate the efficacy of enzymatic sclerostomy in patients with open-angle glaucoma.
  • To explore a new modality for managing elevated intraocular pressure.

Main Methods:

  • A prospective, interventional case series involving 15 eyes with primary open-angle glaucoma.
  • Enzymatic sclerostomy performed using a collagenase-filled applicator affixed to the limbus.

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  • Patients were followed for 1 year to monitor IOP and complications.

    • Main Results:

    • Significant IOP reduction from a mean of 43.5 mmHg to 24.8 mmHg postoperatively (43% decrease).
    • Sustained IOP reduction of 20% at 1 year, with patients off glaucoma medications.
    • Ophthalmic adverse effects were localized; one case of perforation and two of increased IOP occurred.

    Conclusions:

    • Enzymatic sclerostomy shows potential for immediate and sustained IOP reduction in open-angle glaucoma.
    • The procedure provided symptomatic relief in blind, glaucomatous eyes.
    • Further refinement of the enzymatic sclerostomy technique is required for optimal outcomes.