Long-term results of combined deep sclerectomy, cataract surgery show good IOP control

BOSTON — A majority of glaucoma patients who received combined deep sclerectomy and cataract surgery maintained a lower IOP at nearly 10 years follow-up with a minimum number of complications, a study found.

At the World Glaucoma Congress here, Enrico Martini, MD, and colleagues presented their prospective, uncontrolled open series in a poster presentation.

The study examined 140 cases of uncontrolled glaucoma with IOP of more than 21 mm Hg and significant cataract. Patients underwent the same techniques of combined surgery with superior deep sclerectomy and temporal approach phacoemulsification/IOL implantation. The study had a mean follow-up of 76 months.

"In our series, combined deep sclerectomy and phacoemulsification with [posterior chamber] IOL proved to be highly effective for long-term IOP control with a mean reduction of almost 45% at 9 years and a very significant reduction of IOP-lowering drugs (half of the patients are without any therapy), very low complication rate and stable visual field (significant perimetric progression only in 5%)," Dr. Martini and colleagues said.

They said bleb manipulation with needling, 5-fluorouracil and YAG-laser goniopuncture "have to be considered postop routine treatments."