Complications of deep nonpenetrating sclerectomy
Strnad, P.; Svačinová, J.; Vlková, E.
Ceska a Slovenska Oftalmologie Casopis Ceske Oftalmologicke Spolecnosti a Slovenske Oftalmologicke Spolecnosti 68(3): 109-113
2012
ISSN/ISBN: 1211-9059 PMID: 23214459 Document Number: 658788
The purpose of this retrospective study was to evaluate an incidence of complications after deep nonpenetrating sclerectomy with different type of implant. A total of consecutive 92 eyes (76 patients) that underwent deep sclerectomy were divided into 3 groups according to the type of nonpenetrating surgery. The first group underwent deep sclerectomy without implant (34 eyes, 29 patients), the second group underwent deep sclerectomy with absorbable collagen implant Staar© (31 eyes, 25 patients) and the third group underwent deep sclerectomy with non-absorbable implant T-Flux© (27 eyes, 22 patients). The complications were divided into 3 types - peroperative, early postoperative and late postoperative. The incidence of complications in above mentioned 3 groups was as follows: Peroperative complications: Perforation of trabeculo-Descemets membrane (2.6; 4.2; 3.7 % respectively). Early postoperative complications: Filtrating operating wound (no occurrence in our groups), Choroideal detachment (17; 19; 16 % resp.), Hypotony (10; 8; 5 % resp.), Hyphaema (7; 3; 0 % resp.), Infectious complications (no incidence of blebitis or endophthalmitis in our groups), Flat anterior chamber (7; 5.7; 5.5 % resp.), Dislocation of implant (1 case of dislocation of Staar©, 1 case of dislocation of T-Flux©). Late postoperative complications: Fibrosis of filtering bleb (30; 36; 24 % resp.), Encapsulated filtering bleb (2.9; 10.3; 0 %), Peripheral anterior synechiae (0; 4.2; 3.7 % resp.), Cataract progression (total incidence 5.5 %), there was no incidence of chronic hypotony, scleral ectasia and late endophthlamitis in our groups. Deep sclerectomy allows effective lowering of intraocular pressure, without necessity of opening anterior chamber. It brings lower incidence of complications compared to classical penetrating trabeculectomy. Use of implant increases success of surgery due to intrascleral fibrosis reduction. We documented better effect of non-absorbable implant T-Flux© compared to absorbable collagen implant Staar©. The highest incidence of intrascleral fibrosis was in group of patients that underwent deep sclerectomy without implant.