Modified deep sclerectomy for the surgical treatment of glaucoma

Sharifipour, F. and Yazdani, S. and Asadi, M. and Saki, A. and Nouri-Mahdavi, K. (2019) Modified deep sclerectomy for the surgical treatment of glaucoma. Journal of Ophthalmic and Vision Research, 14 (2). pp. 144-150.

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Purpose: To report the short-term outcomes of modified deep sclerectomy (MDS) in the management of open angle glaucoma. Methods: This prospective, non-randomized, controlled study included 105 eyes (105 patients) with open angle glaucoma. Eyes were categorized as follows: trabeculectomy (30 eyes), MDS (27 eyes), phacotrabeculectomy (28 eyes), and phaco-MDS (20 eyes). The MDS technique involved removal of a third scleral flap to expose the suprachoroidal space and excision of a trabecular block. A two-site approach was used for combined surgeries. Main outcome measures included intraocular pressure (IOP), number of glaucoma medications, and complications. Treatment success was defined as an IOP of 6-15 mmHg and/or a 30 reduction in IOP. Results: All groups showed significant decrease in IOP and number of medications (both P s < 0.001). The MDS group had a higher IOP (13.9 ± 3.8 vs. 12.4 ± 2.5 mmHg, P = 0.080) and required more medications (P = 0.001) than the trabeculectomy group at 1 year. The MDS group had a higher baseline IOP than the trabeculectomy group (P = 0.004) and both the groups showed similar IOP reductions (33.3 vs. 25.7, P = 0.391). The phaco-MDS and phacotrabeculectomy groups had comparable IOP (13.3 ± 3.1 vs. 12.4 ± 3.1 mmHg, P = 0.354), number of medications (P = 0.594), and IOP reduction (P = 0.509) at 1-year follow-up visit. The trabeculectomy and phacotrabeculectomy groups developed more wound leaks (P = 0.043) and required more bleb needling during the early postoperative period (P < 0.001). Conclusion: The MDS technique seems to be slightly inferior to trabeculectomy, but when combined with phacoemulsification, is safer and results in similar IOP outcomes. © 2019 Journal of Ophthalmic and Vision Research.

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Sharifipour, F.; Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave., Iran; email:
Uncontrolled Keywords: Glaucoma Glaucoma Surgery Modified Deep Sclerectomy Trabeculectomy
Subjects: WW Ophthalmology
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib1 lib1
Date Deposited: 27 Jun 2020 05:40
Last Modified: 27 Jun 2020 05:40

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