Deep sclerectomy with implant effective in pseudoexfoliation glaucoma

Deep sclerectomy had a higher success rate in patients with pseudoexfoliation glaucoma than in patients with primary open-angle glaucoma, according to a comparative study.

Liv Drolsum evaluated the deep sclerectomy technique prospectively in 28 eyes of 24 patients with pseudoexfoliation glaucoma and 29 eyes of 25 patients with primary open-angle glaucoma (POAG). Patients received one of two types of implant: either STAAR Surgical’s Aqua-Flow, an absorbable collagen implant or IOLTech’s T-Flux, a nonabsorbable hydrophilic acrylic implant.

The number of glaucoma medications, IOP and complications were compared postoperatively. Complete success was defined as and IOP below 19 mm Hg without medical therapy. Mean follow-up was 19.9 months in the pseudoexfoliation group and 16.2 months in the POAG group.

Complete success was achieved in 61% of eyes with pseudoexfoliation glaucoma and 38% of eyes with POAG. Survival analysis demonstrated that success rates were better over time in the eyes with pseudoexfoliation than in the eyes with POAG (P = .038). At all follow-up visits except at 24 months, IOP was lower in the eyes with pseudoexfoliation than in the POAG group. The differences were statistically significant at 1 week and 3 months.

Hyphema occurred more often in the pseudoexfoliation group than in the POAG group.

The study is published in Acta Ophthalmologica Scandinavica.