Publication details

Komplikace u nepenetrujících hlubokých sklerektomií.

Title in English Complications of deep nonpenetrating sclerectomy.
Authors

STRNAD Petr SVAČINOVÁ Jitka VLKOVÁ Eva

Year of publication 2009
Type Article in Proceedings
Conference Sborník abstrakt, XVII. výroční sjezd České oftalmologické společnosti
MU Faculty or unit

Faculty of Medicine

Citation
Field ORL, ophthalmology, stomatology
Keywords Deep sclerectomy; T-Flux©; collagen implant Staar©; laser goniopuncture
Description Objective: The purpose of this retrospective study was to evaluate an incidence of complications after deep nonpenetrating sclerectomy with different type of implant. Methods: A total of consecutive 92 eyes (76 patients) that underwent deep sclerectomy were divided into 3 groups according to the type of nonpenetrating surgery. The first group underwent deep sclerectomy without implant (34 eyes, 29 patients), the seccond group underwet deep scerectomy with absorbable collagen implant Staar© (31 eyes, 25 patients) and the third group underwent deep sclerectomy with non-absorbable implant T-Flux© (27 eyes, 22 patients). The complications were divided into 3 types – peroperative, early postoperative and late postoperative. Results: The incidence of complications in above mentioned 3 groups was as follows: Peroperative complications: Perforation of trabeculo-Descemets membrane (2,6; 4,2; 3,7% respectively). Early postoperative complications: Filtrating operating wound (no occurrence in our groups), Choroideal detachment (17; 19;16% resp.), Hypotony (10; 8; 5% resp.), Hyphaema (7; 3; 0% resp.), Infectious complications (no incidence of blebitis or endophthlamitis in our groups), Flat anterior chamber ( 7; 5,7; 5,5% resp.), Dislocation of implant (1 case of dislocation of Staar©, 1 case of dislocation of T-Flux©). Late postoperative complications: Fibrosis of filtering bleb (30; 36; 24% resp.), Encapsulated filtering bleb (no incidence in our groups), Peripheral anterior synechiae (0; 4,2; 3,7% resp.), Cataract progression (total incidence 5,5%), there was no incidence of chronic hypotony, scleral ectasia and late endophthlamitis in our groups. Conclusions: Based on our results we suggest that deep sclerectomy allows effective lowering of intraocular pressure, without necessity of opening anterior chamber. It brings lower incidence of complications compared to classical penetrating trabeculectomy. Use of implant increases success of surgery due to intrascleral fibrosis reduction. We documented better effect of non-absorbable implant T-Flux© compared to absorbable collagen implant Staar©. The highest incidence of intrascleral fibrosis was in group of patients that underwent deep sclerectomy without implant.

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