Ten Years Follow-up After Deep Sclerectomy With Collagen Implant

Bissig, A.; Rivier, Delphine; Zaninetti, Marc; Shaarawy, Tarek; Mermoud, André; Roy, Sylvain

doi:10.1097/ijg.0b013e318182ed9e

Cited by 83 publications

(92 citation statements)

References 25 publications

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“…In this study the qualified success rate 18 months after surgery was 85%. This rate compared favourably with results for trabeculectomy or DSCI [10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 55%

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Deep sclerectomy with the Ex-PRESS X-200 implant for the surgical treatment of glaucoma

Bissig

Feusier²,

Mermoud³

et al. 2010

Int Ophthalmol

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The efficacy and safety of a newly designed Ex-PRESS X-200 drainage device for the surgical treatment of glaucoma was evaluated. A clinical, prospective, monocentric, non-randomised, unmasked study on patients with medically uncontrolled glaucoma was performed. A superficial scleral flap was created. A posterior deep sclerectomy (DS) was dissected without opening the Schlemm's canal and an Ex-PRESS X-200 device was inserted under the scleral flap into the anterior chamber to drain aqueous humour into the intrascleral space. Biomicroscopy, best-corrected visual acuity (BCVA), applanation intra-ocular pressure (IOP) measurements, and fundus examination were performed before surgery, on the first day, the first week, and 1, 2, 3, 6, 12 and 18 months after surgery. The mean follow-up was 18.6 ± 2.4 months (mean ± SD) for the 26 eyes that were treated with the Ex-PRESS X-200 device. Preoperatively, the mean BCVA was 0.6 ± 0.3, the mean IOP was 22.0 ± 5.1 mmHg, and the mean number of medications per patients was 2.8 ± 0.8. Eighteen months after surgery the mean BCVA was 0.5 ± 0.4, the mean IOP was reduced to 12.0 ± 3.9 mmHg, and the mean number of medications per patient was 0.6 ± 1.2. Eighty-five percent of patients achieved an IOP \ 18 mmHg with or without medication and 69% without medication. Post-operative complications were hyphaema (15%), Seidel (15%), encysted blebs (54%) and bleb fibrosis in 8% of patients. Mitomycin C(MMC) was administered to 15 patients (58%) with needling being performed on 10 (38%) of these patients. Mid-term results of DS with the Ex-PRESS X-200 implant demonstrated its efficacy in controlling IOP with few post-operative complications in difficult eyes with an increased risk of surgery failure.

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“…In this study the qualified success rate 18 months after surgery was 85%. This rate compared favourably with results for trabeculectomy or DSCI [10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 55%

“…Compared to trabeculectomy NPFS offers the advantage of lowering the complication rate with comparable efficiency in controlling IOP [8][9][10]. Despite promising results, deep sclerectomy with collagen implant (DSCI) presents the relative disadvantage of being a difficult technique to perform [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Deep sclerectomy with the Ex-PRESS X-200 implant for the surgical treatment of glaucoma

Bissig

Feusier²,

Mermoud³

et al. 2010

Int Ophthalmol

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“…11,16,17 Excellent long-term results have been reported with DS as the primary surgery for open-angle glaucoma. [18][19][20] The IOP after DS can be further lowered by Nd:YAG laser goniopuncture (LGP) of the TDM. 21,22 Like with trabeculectomy, intraoperative mitomycin C (MMC) application results in lower IOPs in the long term 23,24 and bleb rejuvenation techniques like needle revision can be used.…”

Section: Introductionmentioning

confidence: 99%

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Anand

Wechsler²

2011

Eye

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Purpose To report outcomes of deep sclerectomy (DS) with intraoperative mitomycin C (MMC) application in eyes with previous failed glaucoma surgery (GS) and/or cataract extraction (CE). Patients and methods Single-surgeon case series of 82 eyes of 82 patients undergoing DS with MMC. The patients had previous CE with IOL and/or conjunctival GS and treated intraocular pressure (IOP) 418 mm Hg. MMC (0.2 mg/ml) was applied for 2-3 min before scleral flap dissection. Complete success was defined as IOP between 6 and 21 mm Hg or a reduction of 20% from baseline without medications. Reoperation for glaucoma or related complications, or loss of light perception vision was considered as failure. Results Mean follow-up was 57.7±22.4 months with 78% of patients completing the 3-year follow-up. Mean IOP decreased from 24.0 mm Hg (22.3-25.6, 95% confidence intervals) to 13.4 mm Hg (12.0-14.2) at 3 years after surgery (Po0.001). There was a significant decrease in the number of glaucoma medications from 2.0±1 preoperatively, to 0.3±0.7, 3 years after surgery. Kaplan-Meier cumulative success rates were 85.6% at 1 year, 80.0% at 2 years, and 76% at 3 years. At 3 years, IOP was maintained o19 and 15 mm Hg in 83 and 70% of eyes, respectively. Fourteen eyes (17.1%) had complications. Delayed hypotony (IOP o6 mm Hg) was the commonest complication in five eyes (6.1%). Conclusion DS with MMC appears to be a safe and effective surgical procedure for eyes with previous intraocular surgery.

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“…Possible additional outflow paths through the ostia of Schlemm's canal [27] and an outflow into the episcleral veins through subtenon's space, that are present in other glaucoma filtration surgeries [8,19,20,27,29] are demonstrated in Fig. 3, Fig.…”

Section: Long Term Results and Outflow Mechanisms Of Npdsmentioning

confidence: 99%

Non-penetrating intracanalicular partial trabeculectomy via the ostia of Schlemm's canal

Dashevsky

Lanzl

Kotliar

2010

Graefes Arch Clin Exp Ophthalmol

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Ten Years Follow-up After Deep Sclerectomy With Collagen Implant

Cited by 83 publications

References 25 publications

Deep sclerectomy with the Ex-PRESS X-200 implant for the surgical treatment of glaucoma

Deep sclerectomy with the Ex-PRESS X-200 implant for the surgical treatment of glaucoma

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Non-penetrating intracanalicular partial trabeculectomy via the ostia of Schlemm's canal

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