Ten Years Follow-up After Deep Sclerectomy With Collagen Implant

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Abstract

Purpose

To evaluate the long-term success rate and complications of nonpenetrating deep sclerectomy with collagen implant in open-angle glaucoma.

Patients and Methods

Clinical, prospective, monocentric, nonrandomized, unmasked study on 105 patients with medically uncontrolled glaucoma. A standard procedure deep sclerectomy with collagen implant was performed. Complete examinations were performed before surgery and postoperatively at 1 and 7 days; 1, 2, 3, 6, 9, and 12 months and then every 6 months during the 10 following years.

Results

The mean follow-up was 101.5±43.1 (3 to 144) months [mean±SD, (range)]. The preoperative intraocular pressure (IOP) was 26.8±7.7 (14 to 52) mm Hg and the best-corrected visual acuity 0.71±0.33 (0.02 to 1.5). Ten years after surgery IOP was 12.2±4.7 (6 to 20) mm Hg and best-corrected visual acuity 0.63±0.34 (0.01 to 1.2) (number of remaining patients=52). The mean number of medications per patient went from 2.3±0.7 (1 to 4) down to 1.3±1.1 (0 to 3). An IOP ≤21 mm Hg without medication was achieved in 47.7% patients and in 89% with or without treatment. One major complication was reported. Goniopuncture was performed in 61 eyes (59.8%), 5-fluorouracil treatment given to 25 patients postoperatively and included needling (n=5).

Conclusions

On the basis of a 10-year follow-up deep sclerectomy with collagen implant demonstrated its efficacy in controlling IOP with few postoperative complications.

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