A comparison between peripheral iridectomy with thermal sclerostomy and trabeculectomy: a controlled study

Area of Science:

• Ophthalmology
• Glaucoma Surgery

Background:

• Primary open-angle glaucoma (POAG) is a progressive optic neuropathy.
• Surgical intervention is often necessary for advanced POAG to prevent further vision loss.

Purpose of the Study:

• To compare the efficacy and safety of peripheral iridectomy with thermal sclerostomy versus trabeculectomy in POAG patients.
• To evaluate intraocular pressure control, complication rates, and visual field outcomes between the two surgical techniques.

Main Methods:

• A randomized trial involving 15 POAG patients requiring surgery in both eyes.
• One eye received peripheral iridectomy with thermal sclerostomy, the other received trabeculectomy.
• Outcomes assessed included complication rates, intraocular pressure (IOP), and visual field status at one and five years.

Main Results:

• Peripheral iridectomy with thermal sclerostomy showed a higher immediate complication rate compared to trabeculectomy.
• Lower average final intraocular pressure (16 mmHg vs. 22 mmHg) was observed with peripheral iridectomy with thermal sclerostomy.
• Disease control and visual field stability were comparable, though trabeculectomy eyes more frequently required additional medical therapy.

Conclusions:

• Peripheral iridectomy with thermal sclerostomy may achieve lower IOP through gross filtration but carries a higher complication risk.
• Trabeculectomy provides comparable disease control but may necessitate supplementary medical treatment.
• Both surgical options demonstrate effectiveness in managing progressive POAG, with distinct risk-benefit profiles.