Efficacy and Safety of Deep Sclerectomy With the Esnoper Clip Implant for Uncontrolled Primary Open Angle Glaucoma: A 1 Year Prospective Study.
Baxant Alina-Dana, Klimešová Yun Min, Holubová Lucie, Pluhovský Patrik, Bartošová Jitka, Veselý Ľudovít, Nemčoková Martina, Rosina Jozef, Studený Pavel
AI Summary
Deep sclerectomy with Esnoper Clip effectively and safely lowered IOP in uncontrolled POAG, achieving an 87.2% complete success rate at one year, reducing medication dependence.
Abstract
Prcis: Deep sclerectomy (DS) with the Esnoper Clip drainage implant in patients with uncontrolled primary open angle glaucoma (POAG) achieved a complete success rate of 87.2% at the 1-year follow-up.
Purpose
To investigate the efficacy and safety of DS followed by Esnoper Clip implantation in patients with uncontrolled POAG.
Materials and methods
In a prospective, consecutive, interventional study, we investigated 39 eyes of 35 patients with uncontrolled POAG who underwent DS with Esnoper Clip implantation. Complete ophthalmologic examinations including corrected visual acuity and intraocular pressure (IOP), were performed preoperatively, and at 1 day, at 1 week as well as at 1, 3, 6, 9, and 12 months postoperatively. Moreover, any goniopunctures and glaucoma medications required postoperatively were noted.
Results
The mean preoperative IOP was 20.8±5.2 mm Hg and it decreased to 13.9±3.1 mm Hg at 1 year postoperatively ( P <0.001). The number of glaucoma medications decreased from 2.9±0.7 preoperatively to 0.3±0.8 after 1 year ( P <0.001). The complete success rate (IOP≤21 mm Hg without glaucoma medication) and the qualified success rate (IOP ≤21 mm Hg with or without glaucoma medication) were 87.2% and 94.9%, respectively. Goniopuncture was performed in 33.3% of cases. No significant corrected visual acuity changes were registered at the final follow-up. Perioperative complications consisted of 3 micro-perforations of the trabeculo-descemet membrane. Postoperative complications included: hyphema (6 eyes), hypotony (6 eyes), shallow anterior chamber (3 eyes), choroidal detachment (4 eyes)-all of which were resolved without surgical intervention during the first postoperative month-and conjunctival dehiscence, which required resuture (2 eyes).
Conclusion
Deep sclerectomy with the Esnoper Clip implant was safe and effectively lowered IOP in patients with uncontrolled POAG.
MeSH Terms
Shields Classification
Key Concepts6
Deep sclerectomy (DS) with the Esnoper Clip drainage implant achieved a complete success rate of 87.2% (IOP≤21 mm Hg without glaucoma medication) at the 1-year follow-up in patients with uncontrolled primary open angle glaucoma (POAG).
The mean preoperative intraocular pressure (IOP) of 20.8±5.2 mm Hg in patients with uncontrolled primary open angle glaucoma (POAG) decreased to 13.9±3.1 mm Hg at 1 year postoperatively (P <0.001) after deep sclerectomy with Esnoper Clip implantation.
The number of glaucoma medications decreased from 2.9±0.7 preoperatively to 0.3±0.8 after 1 year (P <0.001) in patients with uncontrolled primary open angle glaucoma (POAG) who underwent deep sclerectomy with Esnoper Clip implantation.
Deep sclerectomy (DS) with the Esnoper Clip drainage implant achieved a qualified success rate of 94.9% (IOP ≤21 mm Hg with or without glaucoma medication) at the 1-year follow-up in patients with uncontrolled primary open angle glaucoma (POAG).
Perioperative complications of deep sclerectomy with Esnoper Clip implantation in patients with uncontrolled primary open angle glaucoma (POAG) included 3 micro-perforations of the trabeculo-descemet membrane.
Postoperative complications of deep sclerectomy with Esnoper Clip implantation in patients with uncontrolled primary open angle glaucoma (POAG) included hyphema (6 eyes), hypotony (6 eyes), shallow anterior chamber (3 eyes), choroidal detachment (4 eyes) which resolved without surgical intervention, and conjunctival dehiscence (2 eyes) which required resuture.
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