[External trabeculecomy (ETE): an alternative? A retrospective comparison with goniotrepanation]

Area of Science:

• Ophthalmology
• Surgical Procedures
• Glaucoma Treatment

Background:

• Glaucoma management often requires surgical intervention to reduce intraocular pressure (IOP).
• Deep sclerectomy and trabeculectomy are established surgical techniques for glaucoma.
• Comparing their efficacy and safety is crucial for clinical decision-making.

Purpose of the Study:

• To compare the effectiveness of deep sclerectomy versus trabeculectomy in reducing IOP.
• To evaluate and compare complication rates associated with each surgical procedure.
• To assess long-term success rates and re-operation needs for both techniques.

Main Methods:

• A retrospective study involving 199 patients undergoing deep sclerectomy and 80 patients undergoing trabeculectomy.
• Data collected between 2000 and 2005.
• Evaluation of IOP reduction, visual acuity, success rates, complications, and re-operation rates.

Main Results:

• Deep sclerectomy achieved a mean IOP reduction of 23.8% after one year, while trabeculectomy achieved 46.4%.
• Trabeculectomy demonstrated a higher success rate (56.3%) compared to deep sclerectomy (36.7%) over extended follow-up periods.
• Re-operation rates were 21.6% for deep sclerectomy and 17.5% for trabeculectomy, with higher post-operative medication needs for deep sclerectomy patients.

Conclusions:

• Both deep sclerectomy and trabeculectomy can achieve a target IOP below 18 mmHg within one year.
• Deep sclerectomy serves as an effective alternative to trabeculectomy in specific scenarios, particularly when less IOP lowering is desired or in high-risk eyes.
• The choice of procedure should be guided by individual patient factors and treatment goals.