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Updated: May 19, 2026
05:05
Ultrasound Cyclo Plasty in Eyes with Glaucoma
Published on: January 26, 2018
[Filtering surgery in glaucoma: comparative study of three surgical approaches].
J-M Baumgartner1, C E Ngondi, J Bovet
1OnO, Ophthalmology Network Organisation, clinique de l'œil SA, avenue Bois-de-la-Chapelle 15, 1213 Onex, Genève, Suisse.
Journal Francais D'Ophtalmologie
|August 29, 2012
Summary
Deep sclerectomy with an autologous corneal implant soaked in mitomycin C effectively lowers intraocular pressure for primary open-angle glaucoma patients. This technique shows promising medium-term efficacy and may improve surgical success rates.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Innovation
Background:
- Trabeculectomy complications led to the resurgence of non-penetrating glaucoma surgery (NPGS) in the 1980s.
- Modifications to NPGS aim to enhance success rates and patient safety.
- A novel deep sclerectomy (DS) variation utilizes an autologous corneal stromal implant soaked in mitomycin C.
Purpose of the Study:
- To introduce and evaluate a new deep sclerectomy (DS) technique.
- To compare the efficacy of DS with an autologous corneal implant (mitomycin C-soaked) against standard DS and conventional trabeculectomy.
- To assess intraocular pressure (IOP) reduction at two years post-surgery.
Main Methods:
- A comparative study involving three surgical groups: DS (I), DS with autologous implant (II), and conventional trabeculectomy (III).
- 40 eyes with medically uncontrolled primary open-angle glaucoma (POAG) in group I, 22 in group II, and 15 in group III.
- All surgeries performed by a single surgeon, with 24-month follow-up including standard exams and Visante OCT for anterior segment analysis.
Main Results:
- No significant differences in preoperative IOP or demographics across the three groups.
- Mean postoperative IOP was significantly lower in group II (DS with autologous implant) at 12 months (13 ± 3 mmHg) compared to groups I and III (P=0.02).
- At 24 months, group II maintained lower IOP (12 ± 3 mmHg) than group I (15 ± 4 mmHg), though not statistically significant (P=0.2); however, medication use dropped significantly across all groups (P=0.02).
- Visible implants under the bleb at 24 months correlated with better outcomes.
Conclusions:
- Deep sclerectomy with an autologous, mitomycin C-soaked corneal implant demonstrates significant IOP reduction at 12 and 24 months.
- This technique appears more effective than collagen implants, likely due to implant persistence and reduced fibrosis.
- The procedure is an inexpensive, medium-term effective option for POAG management, potentially enhancing success rates and IOP control.
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