Supraciliary hema implant in combined deep sclerectomy and phacoemulsification: one year results

Abstract

We present the combined surgery of non-penetrating deep sclerectomy with insertion of the implant in the supraciliary space as an effective and safe surgery for patients with both cataract and primary open angle glaucoma. This study included 20 eyes of 16 patients who were followed up during 12 months. We found a significant intraocular pressure reduction, changing from a preoperative mean of 23 ± 5 mmHg to a postoperative mean of 18 ± 3 mmHg (p<0.002). Similarly, a significant reduction in the number of glaucoma drugs needed was observed, varying from 2.5 ± 0.9 drops per patient to 0.7 ± 0.9 (p<0.0002) at the end of the study. We also report a significant improvement in best-corrected visual acuity, from 5/10 ± 2/10 to 8/10 ± 2/10 (p<0.006), one year after the combined surgery. The only intraoperative complication observed was the microperforation of the trabeculo-descemetic membrane (TDM) and postoperative complications were iris incarceration, seidel test positivity and microhyphema. All these complications resolved successfully.

Keywords: Open angle glaucoma; combined surgery; deep sclerectomy; non-penetrating glaucoma surgery; suprachoroidal implant..

Fig. (1)

Hema implant model. (V-2000, Esnoper^®, AJL Ophthalmics, Álava, Spain).

Fig. (2)

An intraoperatory image of the implant placement in the supraciliary space while being sutured.

Fig. (3)

Ultrasound biomicroscopy of a bleb. The red arrows show the subconjunctival (A), intraescleral (B) and supraciliary (C) spaces for aqueous drainage.