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Minimally invasive sclerotomy procedure shows stable results in long term
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PARIS — High-frequency deep sclerotomy is a safe, minimally invasive glaucoma procedure that effectively lowers IOP, according to one specialist.
By decreasing the resistance of the trabecular meshwork, high-frequency deep sclerotomy allows aqueous outflow into Schlemm’s canal, Bojan Pajic, MD, explained at the meeting of the French Society of Ophthalmology. Using a diathermic probe (Abee Glaucoma Tip, Oertli Instruments) with an external diameter of 0.8 mm, bipolar radiofrequency energy is applied through the trabecular meshwork into Schlemm’s canal and then 1 mm into the sclera.
Bojan Pajic
"We perform six of these deep sclerotomy pockets within the same quadrant. The procedure is easy, only takes 4 to 5 minutes, and is performed through a small 1.2-mm incision. A second incision is used for the viscoelastic," Pajic said.
High-frequency deep sclerotomy was performed in 205 consecutive patients with open-angle glaucoma, in combination with cataract surgery. Follow-up ranged between 4 years and 6 years.
"Mean IOP decreased from 24.5 mm Hg preop to 15 mm Hg at 1 month and is stable at 6 years. The average postoperative administration of pressure-reducing eye agents was 0.48 ± 0.97 at 4 years," Pajic said.
"We are giving pilocarpine to the patients during the first 3 to 4 weeks because an IOP increased was observed in some patients between 1 and 2 weeks, for reasons that are not yet known," he said.
There were no serious complications related to the procedure. Mild, transitory inflammation, hyphema and fibrin formation were observed in a small percentage of patients.
Disclosure: Pajic has no relevant financial disclosures.