Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2004 Jan;88(1):95-8.
doi: 10.1136/bjo.88.1.95.

Comparative study between deep sclerectomy with and without collagen implant: long term follow up

T Shaarawy  1 , C Nguyen, C Schnyder, A Mermoud
Affiliations
Clinical Trial

Comparative study between deep sclerectomy with and without collagen implant: long term follow up

T Shaarawy et al. Br J Ophthalmol. 2004 Jan.

Abstract

Aim: To identify the value of using collagen implant in deep sclerectomy.

Methods: A prospective randomised trial of 104 eyes (104 patients) with medically uncontrolled primary and secondary open angle glaucoma. All patients had deep sclerectomy (DS), half of them with and the other half without a collagen implant (CI) sutured in the scleral bed. The main outcome measures were intraocular pressure (IOP), visual acuity, number of treatments preoperative and postoperative, and Nd:YAG goniopunctures.

Results: Mean follow up period was 44.5 (SD 21) months for the DS group and 43.9 (SD 14) months for the deep sclerectomy with a collagen implant (DSCI) group. The mean preoperative IOP was 23.3 (SD 7.2) mm Hg for the DS group and 25.6 (SD 4.9) mm Hg for the DSCI group. The mean IOP at the first postoperative day was 6.1 (SD 4.21) mm Hg for the DS group and 5.1 (SD 3.3) mm Hg for the DSCI group. At 48 months IOP was reduced by 40% (14 versus 23.3 mm Hg) for the DS group and by 50% (12.7 versus 25.6 mm Hg) for the DSCI group. Complete success rate, defined as IOP lower than 21 mm Hg without medication, was 34.6% (18/52 patients) at 48 months for the DS group, and 63.4% (33/52 patients) for the DSCI group. Qualified success rate; patients who achieved IOP below 21 mm Hg with or without medication, was 78.8% (41/52 patients) at 48 months and 94% (49/52 patients) for the DSCI group. The mean number of medications was reduced from 2.1 (SD 0.8) to 1.0 (SD 1) after DS, and was reduced from 2.2 (SD 0.7) to 0.4 (SD 0.6) in the DSCI group (p = 0.001)

Conclusion: The use of a collagen implant in DS enhances the success rates and lowers the need for postoperative medication.

PubMed Disclaimer

Figures

Figure 1
Figure 1
One third 5×5 scleral thickness flap is dissected.
Figure 2
Figure 2
4×4 Deep scleral flap is dissected and excised unroofing Schlemm’s canal.
Figure 3
Figure 3
The collagen implant is sutured in the scleral bed.
Figure 4
Figure 4
The superficial flap is repositioned, loosely tied, and the conjunctiva and Tenon are closed.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Akafo SK, Goulstine DB, Rosenthal AR. Long-term post trabeculectomy intraocular pressures. Acta Ophthalmol (Copenh) 1992;70:312–6. - PubMed
    1. Brubaker RF, Pederson JE. Ciliochoroidal detachment. Surv Ophthalmol 1983;27:281–9. - PubMed
    1. D’Ermo F, Bonomi L, Doro D. A critical analysis of the long-term results of trabeculectomy. Am J Ophthalmol 1979;88:829–35. - PubMed
    1. Freedman J, Gupta M, Bunke A. Endophthalmitis after trabeculectomy. Arch Ophthalmol 1978;96:1017–18. - PubMed
    1. Gressel MG, Parrish RK, Heuer DK. Delayed nonexpulsive suprachoroidal hemorrhage. Arch Ophthalmol 1984;102:1757–60. - PubMed

Publication types