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Study: Deep sclerectomy with phaco equivalent to phacotrabeculectomy
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BUENOS AIRES — Performing nonpenetrating deep sclerectomy with phacoemulsification can result in IOP reductions equivalent to phacotrabeculectomy, according to a study presented here at the Argentinean Society of Ophthalmology Congress.
"Both techniques showed to be effective in the control of IOP over the [study period]," Alejandro F. Gonella, MD, said.
Dr. Gonella and colleagues evaluated the IOP reductions and complication rates of 60 eyes treated with nonpenetrating deep sclerectomy and phacoemulsification. They compared the results to a group of 33 eyes that received phacotrabeculectomy, according to the study.
Preoperatively, IOP averaged 19.58 mm Hg for patients in the deep sclerectomy group and averaged 22.04 mm Hg for patients in the phacotrabeculectomy group. Both groups were using an average of two glaucoma medications.
Dr. Gonella and colleagues found that both groups had similar reductions in IOP after surgery. However, patients treated with the nonpenetrating procedure experienced fewer immediate postoperative complications. They also had a better initial visual acuity, less inflammation and less hypotony, he said.
Mean IOPs remained similar between the two groups up to 6 years follow-up. After 6 years, patients treated with phacotrabeculectomy had a lower average IOP, although the difference was not statistically significant, Dr. Gonella said.
At 6 years, IOP averaged 14 mm Hg for the phacotrabeculectomy group and 16 mm Hg for the deep sclerectomy group. Both groups used less than one glaucoma medication on average.
Dr. Gonella noted that nonpenetrating deep sclerectomy with phaco has a steep learning curve. But once learned, the procedure can offer advantages over phacotrabeculectomy in selected cases, he said.