PHACO-NON-PENETRATING DEEP SCLERECTOMY (Phaco-NPDS) VERSUS PHACO EX-PRESS SHUNT FOR PSEUDOEXFOLIATIVE GLAUCOMA; ONE-YEAR OUTCOMES

  • 28 junio, 2016
  • 2016
PHACO-NON-PENETRATING DEEP SCLERECTOMY (PHACO-NPDS) VERSUS PHACO EX-PRESS SHUNT FOR PSEUDOEXFOLIATIVE GLAUCOMA; ONE-YEAR OUTCOMES

PHACO-NON-PENETRATING DEEP SCLERECTOMY (Phaco-NPDS) VERSUS PHACO EX-PRESS SHUNT FOR PSEUDOEXFOLIATIVE GLAUCOMA; ONE-YEAR OUTCOMES

Trabajo presentado en: 12th EGS Congress 2016
Autores: Puerto-Hernández B., Sánchez-Sánchez C., Contreras I., Oblanca N., Blázquez-Sánchez V., López-Caballero C. 

Purpose

To compare the intraocular pressure (IOP) and requirement of ocular hypotensive treatment at 1,3,6 and 12 months after surgery, in eyes with pseudoexfoliative-glaucoma (PXG) treated by Phaco-NPDS versus Phaco-Express.

 

Methods

The records of all patients with PSX glaucoma who had undergone combined cataract and glaucoma surgery in our center between 2012 and 2015 were considered for inclusion. Inclusion criteria were PXE diagnosis and one year follow-up period after surgery. Eyes with intraoperative complications or previous glaucoma surgeries were excluded. IOP and the number of topical drugs were studied.

 

PHACO-EXPRESS-SHUNT

PHACO EX-PRESS SHUNT FOR PSEUDOEXFOLIATIVE GLAUCOMA

PHACO-NPDS

PHACO-NON-PENETRATING DEEP SCLERECTOMY (Phaco-NPDS) FOR PSEUDOEXFOLIATIVE GLAUCOMA


Results

Nineteen PXG eyes were included, 12 treated by Phaco-NPDS and 7 by Phaco-Express. There were no statistically significant differences in age, IOP and number of pre-surgery treatments between both groups.

Mean pre-surgical IOP in Phaco-NPDS was 20.1 ± 7.6 mmHg and decreased by 36% at first month, 41% at third and sixth months and a 31% at one year after surgery. Number of hypotensive drugs needed before surgery (2.67) decreased to 0.08± 0.28, 0.09 ± 0.30, 0.11 ± 0.33 and 0.00, at one, three, six and twelve months after surgery respectively. No patients required goniopuncture in the first post-surgery year.

Mean IOP in Phaco-Express group decreased from 19.5 ± 6.1 mmHg by 30%, 39%, 33% and 35% at one, three, six and twelve months post-surgery respectively.

Number of drugs decreased from 2.71 pre-surgery to 0.17 ± 0.48, 0.00, 0.33 ± 0.81 and 1.00 ±1.54 at 1, 3, 6 and 12 months respectively.

No statistically significant differences between groups was observed except for the number of hypotensive drops needed at 1 year after surgery: 1 in Phaco-Express vs 0 in Phaco-NPDS (p<0,05).

 

Conclusions

Both surgical techniques achieved excellent IOP control during the first year after surgery in eyes with PXE. However, more hypotensive topical treatments were needed to control the IOP 1 year after surgery in the Phaco-Express group.

 

Bibliography

– Gonzalez-Rodriguez JM, Trope GE, Drori-Wagschal L, Jinapriya D, Buys YM. Comparison of trabeculectomy versus Ex-PRESS: 3-year follow-up. Br J Ophthalmol. 2015 Dec 16.

– Suominen SM, Harju MP, Vesti ET.  Deep sclerectomy in primary open-angle glaucoma and exfoliative glaucoma. Eur J Ophthalmol. 2016.

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