Combined surgery for cataractand glaucoma: Phacoemulsification and deep sclerectomy compared with phacoemulsification and trabeculectomy

Gianoli, Fabrice; Schnyder, C; Bovey, Etienne H.; Mermoud, André

doi:10.1016/s0886-3350(99)80081-9

Cited by 99 publications

(76 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9,10,20,21 Other studies reported DS and TE being equally effective. [6][7][8]11 Our results are similar to the results after trabeculectomy as reported in clinical trials comparing viscocanalostomy and TE (follow-up 1 year). 10,20 Regarding a retrospective long-term analysis comparing intensified postoperative care and conventional follow-up, the long-term complete success rate after Erbium YAG-laser-assisted deep sclerectomy is superior to the results after conventional follow-up and inferior to intensified postoperative care after trabeculectomy.…”

Section: Discussionsupporting

confidence: 79%

“…22 The concept of reducing early postoperative complications from penetrating glaucoma surgery by performing DS was confirmed in most studies evaluating nonpenetrating procedures. 3,[5][6][7][8][9]11 In our study, the rate of complications was low. The single patient with intraoperative perforation of the TDM and subsequent iridectomy developed a flat anterior chamber and choroidal detachment.…”

Section: Discussionmentioning

confidence: 88%

“…DS was introduced by Krasnov 1 and developed further by Stegmann et al, 2 who added viscocanalostomy. Subsequently, various modifications were proposed, [3][4][5] yielding controversial results: several studies have shown that DS is comparable or less effective, [6][7][8][9][10][11] others that it is superior to standard TE in the treatment of open-angle glaucoma. 2,3 All authors described fewer early postoperative complications using this nonpenetrating technique than with TE.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 All authors described fewer early postoperative complications using this nonpenetrating technique than with TE. 3,[5][6][7]11 The dissection of the deep corneoscleral lamella is the most difficult part of the procedure. Previous studies showed that the dissection of the deep corneoscleral lamella with the Erbium YAG-laser might greatly simplify this delicate step, resulting only in a small thermal damage zone.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Long-term results of Erbium YAG-laser-assisted deep sclerectomy

Klink

Schlunck

Lieb

et al. 2006

Eye

View full text Add to dashboard Cite

Purpose To evaluate the long-term results of Erbium YAG-laser-assisted deep sclerectomy (DS). In this procedure, the delicate dissection of a deep corneoscleral lamella is greatly simplified by using the Erbium YAG-laser. Methods Data of 14 consecutive patients (10 male, four female, age 67.7710.4 years), who underwent surgery from 1999 to 2000 were analysed retrospectively. The procedure was begun as a standard DS. The deep corneoscleral lamella was dissected with a pulsed Erbium YAG-laser (energy: 40-100 mJ, frequency: 5-10 Hz). Schlemm's canal was unroofed and the lamella thinned until aqueous percolated continuously through the membrane. Results The mean follow-up time was 50.476.8 months. The mean preoperative intraocular pressure (IOP) was 37.7710.5 mmHg. The mean postoperative IOP was 16.173.9 mmHg at 1 month, 15.174.3 mmHg at 3 months, 16.474.5 mmHg at 12 months, and 17.678.7 mmHg at 50.5 months. The complete success rates (IOPp21 mmHg þ IOP reduction X20% without glaucoma medication) were 83.3% at 3 months and 50% at 12 and 50.5 months. Rates for qualified success (IOPp21 mmHg þ IOP reduction X20% with glaucoma medication) were 91.7% at 3 months, 92.9% at 12 months, and 78.6% at 50.5 months. The number of glaucoma medications was reduced from 3.0770.92 preoperatively to 1.1471.41 at 50.5 months. A single case of anterior-chamber penetration, requiring iridectomy, was the only intraoperative complication. Conclusions Erbium YAG-laser-assisted DS has the advantage of a greatly simplified dissection, while offering a successful long-term IOP control comparable to conventional DS.

show abstract

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-term results of Erbium YAG-laser-assisted deep sclerectomy

Klink

Schlunck

Lieb

et al. 2006

Eye

View full text Add to dashboard Cite

show abstract

“…16 Phacoemulsification combined with DS (phaco-DS) has been shown to be as effective as phacoemulsification with trabeculectomy (phaco-trab) in lowering IOP. 14,17 In this large case series, we seek to report the outcomes of phaco-DS from a single UK centre over a 10-year period. To our knowledge, this is the largest cohort to describe this procedure with such long-term follow-up results.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of combined phacoemulsification and deep sclerectomy: a 10-year UK single-centre study

Mercieca

Shevade

Anand

2015

Eye

View full text Add to dashboard Cite

Purpose To report the outcomes of combined phacoemulsification and -deep sclerectomy (phaco-DS) from a single UK centre over a 10-year period. Methods Retrospective analysis of phaco-DS data extracted from an ongoing glaucoma surgery database within Calderdale and Huddersfield NHS Trust. Two hundred and ninety-six eyes of 282 patients were included. Data included patient demographics, pre-and postoperative intraocular pressure (IOP), use of mitomycin C (MMC), spacer device implantation, and follow-up details including surgical success rates. IOP success criteria were: (A) IOP o19 mm Hg and/or 20% decrease from baseline and (B) IOP o16 mm Hg and/or 30% drop from baseline. Results Mean follow-up was 63.5 ± 35.3 months. MMC was applied in 145 eyes (49%). Kaplan-Meier success rates in all eyes for criteria A were 89.1% and 80% with glaucoma medications (qualified success) and 81.2% and 68.3% without medications (unqualified success) at 2 and 5 years, respectively. Qualified success for criteria B was 72.4 and 61.4% and unqualified rates were 67.2 and 55.2% for the same time periods. Repeatedmeasures ANOVA showed significantly lower IOP in the phaco-DS with MMC group up to 3 years postoperatively (P = 0.002). Cox's proportional hazards for criteria B, however, showed no significant effect of MMC application in the long term (P = 0.2). Increasing age and laser goniopuncture were positively associated with success, whereas the absence of spacer devices was negatively associated. At last follow-up, 20% of eyes were on glaucoma medications. Complication rates were low with hypotony rates of 0.68%. Conclusions This study confirms the longterm safety and efficacy of phaco-DS as a primary glaucoma procedure.

show abstract