Nonabsorbable uveoscleral implant increases outflow, reduces IOP

Deep sclerectomy with a nonabsorbable uveoscleral implant increased trabecular and uveoscleral outflow and reduced IOP in patients with open-angle glaucoma, according to a study.

The prospective study included 27 eyes of 27 patients with open-angle glaucoma who underwent deep sclerectomy with an Esnoper Clip (AJL Ophthalmic), a nonabsorbable, foldable uveoscleral HEMA implant designed to maintain the supraciliary and intrascleral spaces and achieve higher intrascleral blebs.

All patients were older than 18 years and followed for 12 months. No intraoperative complications were reported.

Mean IOP decreased from 26.6 mm Hg preoperatively to 15.3 mm Hg at 12 months; the 42.5% decrease was statistically significant (P < .001).

The number of glaucoma drugs decreased from 2.5 per patient preoperatively to 0.3 at 12 months (P < .001).

Mean volume of the intrascleral bleb was 3.9 mm³, and mean height of the bleb was 0.7 mm.

The most common postoperative complications were a positive Seidel test result at 24 hours in two eyes, hyphema in two eyes and choroidal detachment in one eye, all of which resolved.

Four eyes required additional mitomycin C injections; two of those eyes required two injections.

Nd:YAG laser goniopuncture was performed in 12 eyes (44.4%) a mean 4.3 months after implant surgery, with mean IOP decreasing from 19.2 mm Hg to 15.5 mm Hg (P < .001).

There were no significant differences between preoperative and postoperative best corrected visual acuity. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

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Source:

Loscos-Arenas J, et al. J Glaucoma. 2015;doi:10.1097/IJG.0000000000000253.