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Better wound healing control is key to nonpenetrating glaucoma surgery
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THOROFARE, N.J. — Modulating wound healing after glaucoma surgery may allow surgeons to provide better filtration and lower postop intraocular pressure levels, said Philippe Sourdille, MD.
"It's a basic phenomenon of surgery: the tissue you have removed naturally tends to be replaced by something. Consequently, filtration becomes less efficient," Dr. Sourdille said.
The French surgeon speaks about issues of wound healing in glaucoma surgery in the upcoming Nov. 1 issue of Ocular Surgery News.
Success of nonpentrating deep sclerectomy depends upon a well-functioning decompression chamber, Dr. Sourdille said. Drugs or surgical techniques that keep the decompression chamber patent for a longer time should help improve the success rate of the procedure, he said.
"Non-penetrating surgery has a much lower rate of complications than trabeculectomy," he said. "However, because we are still confronted with a significant number of failures in terms of IOP lowering, we much still work at improving the technique."
Intraocular pressure (IOP) levels hovering between 17 mm Hg and 20 mm Hg are too high to be safe, he said. Ideally, IOP levels between 10 mm Hg and 12 mm Hg will "guarantee that at least 90% to 95% of the patients will not suffer from visual field deterioration for many years," Dr. Sourdille said.
Efforts in the medical community should be more focused on early detection than they are, he added. Too often surgery is performed at an advanced stage of the disease.