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Related Experiment Videos

A modified deep sclerectomy with or without external trabeculectomy: a comparative study.

George Kitsos1, Miltiades Aspiotis, Yannis Alamanos

  • 1Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece. gkitsos@cc.uoi.gr

Clinical Ophthalmology (Auckland, N.Z.)
|July 3, 2010
PubMed
Summary

Adding external trabeculectomy to reversed deep sclerectomy (RDS) significantly improves glaucoma surgery outcomes. This combined procedure, removing the inner wall of Schlemm's canal, led to higher success rates and greater intraocular pressure reduction compared to RDS alone.

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Phacoemulsification versus Phacoemulsification/Trabeculectomy for the Treatment of Primary Open-Angle Glaucoma Coexistent with Cataract: A Comparative Study.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Surgical Innovation

Background:

  • Open-angle glaucoma (OAG) management often requires surgical intervention to lower intraocular pressure (IOP).
  • Deep sclerectomy (DS) is a surgical technique used to treat glaucoma.
  • Modified techniques aim to enhance the efficacy of DS.

Purpose of the Study:

  • To evaluate the effectiveness of a modified deep sclerectomy (RDS) combined with external trabeculectomy (removal of the inner wall of Schlemm's canal).
  • To compare the outcomes of RDS with external trabeculectomy against RDS alone in patients with open-angle glaucoma.

Main Methods:

  • A prospective study involving two groups of patients with OAG under maximum medical treatment.
  • Group A (22 eyes) underwent RDS with external trabeculectomy without implants.
Keywords:
external trabeculectomymodified deep sclerectomy

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  • Group B (20 eyes) underwent RDS alone, serving as a control group. Mean follow-up was approximately 23 months.

    • Main Results:

    • Total success (IOP < 21 mmHg without additional treatment) was significantly higher in Group A (81.8%) compared to Group B (40%) (P < 0.05).
    • Mean postoperative IOP reduction was greater in Group A (48.1%) than in Group B (25.6%) (P < 0.001).
    • Patients in Group A required a greater reduction in IOP-lowering medications (3.2 vs 1.7 drugs, P < 0.001).

    Conclusions:

    • The addition of external trabeculectomy to reversed deep sclerectomy (RDS) significantly enhances surgical effectiveness for open-angle glaucoma.
    • Removing the inner wall of Schlemm's canal during RDS is a key factor in improving long-term IOP control.
    • This combined surgical approach offers a promising option for managing refractory open-angle glaucoma.