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Immediate postop IOP drop a good indicator in deep sclerectomy

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Patients undergoing deep sclerectomy may prolong its success if initial IOP drops significantly during the first postoperative day, according to a study.

Tarek Shaarawy, MD, and colleagues at Jules Gonin Eye Hospital in Switzerland prospectively enrolled 105 eyes of 105 patients with medically uncontrolled primary and secondary open-angle glaucoma who were undergoing deep sclerectomy. Examination was before surgery and at 1 and 7 days, and 1, 3, 6, 9, 12, 18, 24, 30, 36, 48, 54, 60 and 66 months postop.

The mean preoperative IOP was 26.8 mm Hg; mean postop IOP was 5.1 mm Hg at day 1, increasing to 11.8 mm Hg at month 60. Patients with a first postop day IOP of 5 mm Hg or less were able to keep the sclerectomy successful for 24 months. Patients whose first postop day IOP was more than 5 mm Hg took a median time of 6 months before failure. Postop glaucoma medications were not relevant in time-to-fail rates, the researchers said.

The study is published in the May issue of British Journal of Ophthalmology.