A prospective, controlled study to compare the Scheie procedure with Watson's trabeculectomy

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Techniques

Background:

• Lack of comparative studies hinders surgical decisions for open-angle glaucoma.
• Surgeons rely on experience and published reports, often without prospective controlled data.
• This study addresses the need for evidence-based comparison of glaucoma surgical procedures.

Purpose of the Study:

• To compare the efficacy and outcomes of the Scheie procedure (thermal sclerostomy) versus trabeculectomy for primary open-angle glaucoma.
• To evaluate intraocular pressure control, visual acuity, and complication rates between the two surgical techniques.

Main Methods:

• A prospective, randomized study involving 15 patients with primary open-angle glaucoma.
• Each patient underwent a Scheie procedure in one eye and a trabeculectomy in the fellow eye.
• Standardized surgical techniques were employed, with outcomes assessed over a five-year period.

Main Results:

• Central visual acuity remained comparable between the Scheie procedure and trabeculectomy groups after five years.
• The Scheie procedure group showed easier glaucomatous disease control and lower intraocular pressure (16 mm Hg vs. 22 mm Hg).
• Shallow anterior chambers were more frequent with the Scheie procedure, but without significant complications; bleb formation differed between techniques.

Conclusions:

• The Scheie procedure demonstrates superior intraocular pressure reduction and disease management compared to trabeculectomy in primary open-angle glaucoma over five years.
• Both procedures maintain visual acuity, but the Scheie procedure may offer advantages in long-term glaucoma control.
• Further research with larger cohorts is warranted to confirm these findings and optimize surgical strategies.