Conversion from trabeculectomy to deep sclerectomy. Prospective study of the first 44 cases

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Innovation

Background:

• Trabeculectomy is a common glaucoma surgery, but may require revision or alternative procedures.
• Deep sclerectomy offers a less invasive approach for glaucoma management.
• Drainage implants can enhance the efficacy of filtering surgeries.

Purpose of the Study:

• To evaluate the safety and efficacy of converting from trabeculectomy to deep sclerectomy with a drainage implant.
• To assess the impact on intraocular pressure (IOP) and medication requirements.
• To analyze complication rates following the conversion procedure.

Main Methods:

• A prospective study involving 41 patients (44 eyes) undergoing conversion from trabeculectomy to deep sclerectomy.
• Use of absorbable (AquaFlow) and nonabsorbable (T.Flux) drainage implants.
• Exclusion of patients with multiple prior surgeries, neovascular glaucoma, or children; eyes with accidental membrane perforation were also excluded.

Main Results:

• A significant reduction in mean IOP from 27.9 mmHg preoperatively to 14.6 mmHg at 12 months (P<.001).
• The mean number of glaucoma medications decreased from 3.4 to 0.6 postoperatively (P<.001).
• 61.4% of eyes achieved IOP control without medication; reoperation was needed in only 4.5% of cases, with no significant complications.

Conclusions:

• Conversion to deep sclerectomy with a drainage implant is a safe and effective alternative for managing glaucoma.
• The procedure leads to acceptable postoperative IOP reduction and a decreased need for medications.
• This surgical approach demonstrates a favorable safety profile with a low rate of complications.