Die Rolle des Parathalamus bei der „gedeckten Sklerektomie”

Lambrou, N; Fronimopoulos, J

doi:10.1055/s-2008-1054459

Cited by 2 publications

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“…Some surgeons while performing DS, with or without the use of implant, remove the inner wall of the Schlemm canal, along with the juxtacanalicular trabeculum,4,6,22,44 while others like Mermoud’s team do not 9,11–13,19,23,40,45–47. Folding and not excising part of the deep scleral stroma, in our opinion, enforces the depth of the endoscleral space or parathalamus 48,49. We do not use an implant, but we infuse a small quantity of viscoelastic fluid under the superficial scleral flap after suturing it.…”

Section: Discussionmentioning

confidence: 87%

Results of a modified non-penetrating deep sclerectomy in the treatment of open angle glaucoma with or without cataract

Kitsos

Aspiotis²,

Alamanos³

et al. 2010

OPTH

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Purpose:To present the technique of a modified deep sclerectomy, which we will call “reversed” deep sclerectomy (RDS) and the results and our observations of its use in patients with open angle glaucoma (OAG) and with or without cataract extraction (phacoemulsification).Materials and methods:This prospective study included 132 eyes which underwent RDS: 37 eyes (group A) with uncontrolled OAG and 95 eyes (group B) with OAG and visually significant cataract. Mean pressure preoperatively for group A was 24.48 ± 4.92 mmHg and for group B was 22.99 ± 3.00. The mean number of antiglaucoma drugs received was 2.97 ± 0.69 and 2.56 ± 0.73 for groups A and B respectively. The RDS was performed where the deep scleral stroma is prepared in 2 parts, folded and inserted under the lateral sides of the sclerectomy, and the Schlemm’s canal is opened prior to deep scleral stroma preparation. Cataract was extracted by phacoemulsification through the same scleral opening. The follow-up for group A was 22.23 ± 10.18 months and for group B, 25.36 ± 10.12 months.Results:Postoperative intraocular pressure (IOP) ≤ 21 mmHg was achieved for group A in 40.5% without antiglaucoma drugs and 94.6% with antiglaucoma drugs, and for group B in 66.3% and in 94.7% respectively. Mean IOP reduction was 7.02 ± 6.35 mmHg (28.67%, P < 0.05) for group A and 5.26 ± 3.72 mmHg (25.06%, P ≤ 0.05) for group B, while mean drug reduction was 1.97 ± 1.09 (P < 0.01) and 2.14 ± 0.95 (P ≤ 0.01) respectively. 5-Fluorouracil was used in 8 eyes of group A and in 5 eyes of group B.Conclusion:In the follow-up time during which the two groups were under study, the RDS was effective with a few complications, similar to the classic deep sclerectomy using implants or not, with the advantage, in our opinion, of a short learning curve.

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Section: Discussionmentioning

confidence: 87%

Results of a modified non-penetrating deep sclerectomy in the treatment of open angle glaucoma with or without cataract

Kitsos

Aspiotis²,

Alamanos³

et al. 2010

OPTH

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“…Then, using 10–0 nylon sutures, we suture the superficial scleral flap at the two corners. A small quantity of viscoelastic fluid is injected into the endoscleral space or parathalamus41,42 and finally an 8–0 silk suture is placed on the conjunctiva at the limbus.…”

Section: Methodsmentioning

confidence: 99%

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

Kitsos

Aspiotis²,

Alamanos³

et al. 2010

OPTH

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Purpose:To determine whether the removal of the inner wall of Schlemm’s canal (external trabeculectomy) improves the effectiveness of a modified method of deep sclerectomy (DS), which we will call “reversed” deep sclerectomy (RDS).Materials and method:We conducted a prospective study of two groups of patients. Group A included 22 eyes of 18 patients with open angle glaucoma (OAG) under maximum medical treatment, which underwent RDS – a modified method of performing DS – with the removal of the inner wall of Schlemm’s canal (external trabeculectomy) and without using any implant. Group B included 20 eyes of 17 patients which had undergone RDS alone. Demographic and tonometric data of patients of Group A revealed no significant difference from data of patients in Group B. A mean follow up period for Group A was 22.8 months and for Group B was 23.4 months. The outcome of the operations was termed a total success when intraocular pressure (IOP) was <21 mmHg postoperatively, without additional treatment, relative success when IOP was <21 mmHg with additional treatment and a total failure when IOP >21 mmHg with medical treatment.Results:Total success was achieved in 18/22 eyes (81.8%) for Group A and in 8/20 eyes (40%) for Group B (P < 0.05). Relative success was achieved in 22/22 (100%) for Group A and in 17/20 eyes (85%) in Group B (P = NS). Total failure occurred in 0/22 eyes (0%) in Group A and in 3/20 (15%) eyes in Group B (P = NS). The mean postoperative IOP in Group A was 13.5 ± 2.8 mmHg with a reduction of 12.4 ± 4.6 mmHg (48.1%) and in Group B mean postoperative IOP was 18 ± 4.3 mmHg with a reduction of 6.2 ± 6.9 (25.6%) (P < 0.001). Mean drug reduction postoperatively was 3.2 ± 0.9 drugs in Group A and 1.7 ± 1.2 in Group B (P < 0.001).Conclusion:In the follow up time during which the two groups were under study (12–36 months), the removal of the inner wall of Schlemm’s canal while performing RDS proves an important factor in improving its effectiveness.

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Die Rolle des Parathalamus bei der „gedeckten Sklerektomie”

Cited by 2 publications

References 0 publications

Results of a modified non-penetrating deep sclerectomy in the treatment of open angle glaucoma with or without cataract

Results of a modified non-penetrating deep sclerectomy in the treatment of open angle glaucoma with or without cataract

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

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