Deep sclerectomy, punch trabeculectomy help control IOP

Both deep sclerectomy and trabeculectomy with the Crozafon-De Laage punch technique can help control IOP, according to a study. The authors also noted low-dose intraoperative mitomycin C can be considered a “mild enhancement” of deep sclerectomy’s IOL lowering effect without a negative effect on the intraoperative or postoperative safety of the technique.

Salvatore Cillino and colleagues at the University of Palermo in Italy studied 19 eyes that underwent nonpenetrating deep sclerectomy with mitomycin C and 21 eyes that underwent trabeculectomy with the punch technique and mitomycin C. Follow-up was through 12 months. The mean preoperative IOP in the eyes in the deep sclerectomy group was 29.6 mm Hg and 28 mm Hg in the trabeculectomy group.

No significant intergroup differences were found in the success rate. Complete success (without glaucoma medications) and qualified success (with or without glaucoma medications) were assessed. Complete success (IOP less than 21 mm Hg) was found in 15 eyes of the deep sclerectomy group and in 15 eyes of the trabeculectomy group. If the target IOP was dropped to 17 mm Hg or less, complete success occurred in 12 eyes in the deep sclerectomy group and in 13 eyes in the trabeculectomy group. Using the 17 mm Hg cutoff, qualified success was achieved in 13 eyes in the deep sclerectomy group and in 15 eyes in the trabeculectomy group.

The eyes that underwent trabeculectomy were more likely to report hypotony or shallow anterior chamber than those in the deep sclerectomy group.

The study is published in Ophthalmologica.