Post-operative inflammation following deep sclerectomy with collagen implant versus standard trabeculectomy

Abstract

Surgically induced inflammation can be reduced with DSCI. This may be due to the lack of iridectomy, irrigation, and penetration of the anterior chamber. Eyes at increased risk of post-operative inflammation, such as those with uveitic or traumatic glaucoma, may benefit from this procedure. Further studies are needed to evaluate the long-term functional and anatomical outcomes of DSCI.

CO2 laser‐assisted sclerectomy surgery compared with trabeculectomy in primary open‐angle glaucoma and exfoliative glaucoma. A 1‐year follow‐up

“…Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant. The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). In our study, total rates of early complications and the incidence of choroidal detachment following CLASS were significantly lower compared to trabeculectomy (9.1% versus 29.2% and 1.5% versus 18.5%, respectively).…”

“…The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant.…”

CO2 laser‐assisted sclerectomy surgery compared with trabeculectomy in primary open‐angle glaucoma and exfoliative glaucoma. A 1‐year follow‐up

“…Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant. The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). In our study, total rates of early complications and the incidence of choroidal detachment following CLASS were significantly lower compared to trabeculectomy (9.1% versus 29.2% and 1.5% versus 18.5%, respectively).…”

“…The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant.…”

A randomised, prospective study comparing trabeculectomy augmented with antimetabolites with a viscocanalostomy technique for the management of open angle glaucoma uncontrolled by medical therapy

“…These findings are in contrast with those of Chiou et al who found much more prolonged laser flare readings with trabeculectomy compared to deep sclerectomy. 39 It is of note, however, that our flare results were very similar to those of Siriwardena et al who did not find prolonged inflammation after trabeculectomy when compared to phacoemulsification cataract extraction. 40 When designing this study, a great deal of thought was given to the use of intraoperative antimetabolites.…”

Prognostic Value of Gonioscopy after Deep Sclerectomy

“…Park et al suggested that progressive decrease of the postoperative IOP reduction might be related to the decreased size of the subscleral lake (9). This finding has been reported with both hyaluronic acid and collagen implant (11,12). Similarly, we have found that the number of eyes with subscleral space, flap line visualization, and Schwalbe line depression decreased with longer interval between surgery and gonioscopy, explaining why median postoperative IOP and number of glaucoma medications significantly increase with longer follow-up.…”

CO2 laser‐assisted sclerectomy surgery compared with trabeculectomy in primary open‐angle glaucoma and exfoliative glaucoma. A 1‐year follow‐up

“…Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant. The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). In our study, total rates of early complications and the incidence of choroidal detachment following CLASS were significantly lower compared to trabeculectomy (9.1% versus 29.2% and 1.5% versus 18.5%, respectively).…”

“…The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant.…”

A randomised, prospective study comparing trabeculectomy augmented with antimetabolites with a viscocanalostomy technique for the management of open angle glaucoma uncontrolled by medical therapy

“…These findings are in contrast with those of Chiou et al who found much more prolonged laser flare readings with trabeculectomy compared to deep sclerectomy. 39 It is of note, however, that our flare results were very similar to those of Siriwardena et al who did not find prolonged inflammation after trabeculectomy when compared to phacoemulsification cataract extraction. 40 When designing this study, a great deal of thought was given to the use of intraoperative antimetabolites.…”

Prognostic Value of Gonioscopy after Deep Sclerectomy

“…Park et al suggested that progressive decrease of the postoperative IOP reduction might be related to the decreased size of the subscleral lake (9). This finding has been reported with both hyaluronic acid and collagen implant (11,12). Similarly, we have found that the number of eyes with subscleral space, flap line visualization, and Schwalbe line depression decreased with longer interval between surgery and gonioscopy, explaining why median postoperative IOP and number of glaucoma medications significantly increase with longer follow-up.…”

CO2 laser‐assisted sclerectomy surgery compared with trabeculectomy in primary open‐angle glaucoma and exfoliative glaucoma. A 1‐year follow‐up

“…Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant. The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). In our study, total rates of early complications and the incidence of choroidal detachment following CLASS were significantly lower compared to trabeculectomy (9.1% versus 29.2% and 1.5% versus 18.5%, respectively).…”

“…The main advantages of the nonpenetrating glaucoma surgery compared with trabeculectomy, consistent with our findings, are lower rate of complications (Eldaly et al 2014) including lower inflammatory response (Chiou et al 1998), quicker and full visual recovery (Karlen et al 1999) and lack of significant changes in astigmatism (Corcostegui et al 2004;Egrilmez et al 2004). Among our subjects, five patients lost at least one line following CLASS, which was significantly less frequent than in the trabeculectomy group (8%, versus 29%, p < 0.05), and the mean BCVA change following CLASS was not statistically significant.…”

A randomised, prospective study comparing trabeculectomy augmented with antimetabolites with a viscocanalostomy technique for the management of open angle glaucoma uncontrolled by medical therapy

“…These findings are in contrast with those of Chiou et al who found much more prolonged laser flare readings with trabeculectomy compared to deep sclerectomy. 39 It is of note, however, that our flare results were very similar to those of Siriwardena et al who did not find prolonged inflammation after trabeculectomy when compared to phacoemulsification cataract extraction. 40 When designing this study, a great deal of thought was given to the use of intraoperative antimetabolites.…”

Prognostic Value of Gonioscopy after Deep Sclerectomy

“…Park et al suggested that progressive decrease of the postoperative IOP reduction might be related to the decreased size of the subscleral lake (9). This finding has been reported with both hyaluronic acid and collagen implant (11,12). Similarly, we have found that the number of eyes with subscleral space, flap line visualization, and Schwalbe line depression decreased with longer interval between surgery and gonioscopy, explaining why median postoperative IOP and number of glaucoma medications significantly increase with longer follow-up.…”