Prospective pilot study comparing deep sclerectomy outcomes with a long-term and intense corticosteroid treatment versus a standard one

ObjectiveTo compare prospectively intraocular pressure (IOP) results after deep sclerectomy (DS) using a topical short-term corticosteroid treatment (STCT, 1  month) versus a topical long-term and intense corticosteroid treatment (LTCT, 6 months) in a two2  year-follow-up.MethodsPatients with medica...

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Published inBMJ open ophthalmology Vol. 3; no. 1; p. e000165
Main Authors Lanzagorta-Aresti, Aitor, Perez-Lopez, Marta, Davo-Cabrera, Juan Maria, Palacios-Pozo, Elena
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.10.2018
BMJ Publishing Group
Subjects
Glaucoma
Original
Probability
Software
Success
Surgery
Surgical techniques
Sutures
Transplants & implants
Wound healing
United States > US
corticosteroid
glaucoma surgery
wound healing
postoperative treatment
deep sclerectomy
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Summary:ObjectiveTo compare prospectively intraocular pressure (IOP) results after deep sclerectomy (DS) using a topical short-term corticosteroid treatment (STCT, 1  month) versus a topical long-term and intense corticosteroid treatment (LTCT, 6 months) in a two2  year-follow-up.MethodsPatients with medically uncontrolled open angle glaucoma were prospectively recruited and underwent a DS.ResultsWe operated 45 eyes of 45 patients, 22 in STCT group and 23 in LTCT group. Median preoperative IOP was 27 (22–36.75)  mm Hg for STCT and for 25 (22–28) mm Hg for LTCT group without significant difference (p=0.195). Median postoperative IOP was 4 (3–6.25) mm Hg in STCT group versus 2 (0–5)  mm Hg in LTCT at day 1 (p=0.003); 8.5 (5.75–11.25)  mm Hg (STCT) vs 6 (4–9) mm Hg (LTCT) at week 1 (p=0.079); 17.5 (14.75–22.25)  mm Hg (STCT) vs 13 (10–14) mm Hg (LTCT) at month 1 (p=0.001); 16 (12–20) mm Hg (STCT) vs 12 (10–15) mm Hg (LTCT) at month 3 (p=0.008); 17 (14–20) mm Hg (STCT) vs 12 (10–14) mm Hg (LTCT) at month 6 (p=0.000); 16 (14–20) mm Hg (STCT) vs 14 (10–16) mm Hg (LTCT) at year 1 (p=0.002) and 17.5 (15–19)  mm Hg (STCT) vs 14 (12–16) mm Hg (LTCT) at year 2 (p=0.001). The complete success rate was 54.5 % in STCT and 87 % in LTCT (p=0.018).ConclusionsA long-term and intensive postoperative treatment enhances success rate in DS compared with a standard protocol.
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ISSN:2397-3269
2397-3269
DOI:10.1136/bmjophth-2018-000165