Deep sclerectomy shows long-term safety and efficacy
COPENHAGEN, Denmark — Fifteen years of follow-up with deep sclerectomy show that the technique maintains a steadily high success rate, with IOP in the range of 11 mm Hg to 13 mm Hg, according to one specialist.
“Reports comparing trabeculectomy to deep sclerectomy performed between 1997 and 2011 show equal success in terms of IOP drop and fewer complications,” André Mermoud, MD, said at the European Glaucoma Society meeting.
Mermoud, one of the pioneers of deep sclerectomy, discussed the influence of the learning curve and personal surgeon ability on results.
“It’s a technique that needs practicing to perform a proper dissection and should be adopted only by surgeons who have a fairly high and regular number of patients to treat. On the other hand, I have residents who do it well from the very first time, and other residents who have difficulties in performing it even after 1 year of steady practice,” he said.
Other factors that influence the results of deep sclerectomy are the use of space maintainers such as collagen implants and HealaFlow (Anteis) to create an intrascleral bleb, Nd:YAG goniopuncture and the use of anti-metabolites.
“Except for angle closure, deep sclerectomy is an effective technique for all types of glaucoma. It is particularly suitable for difficult cases such as end-stage glaucoma and myopic glaucoma, where you want a slow decrease in IOP during surgery, and for uveitis glaucoma because it induces less inflammation postoperatively,” Mermoud said.
- Disclosure: Mermoud has no relevant financial disclosures.