Deep Sclerectomy With a New Nonabsorbable Uveoscleral Implant (Esnoper-Clip): 1-Year Outcomes.
Loscos-Arenas Jordi, Parera-Arranz Angels, Romera-Romera Pau, Castellvi-Manent Jordi, Sabala-Llopart Antoni, de la Cámara-Hermoso Julio
AI Summary
Deep sclerectomy with Esnoper-Clip effectively lowered IOP and medication needs in open-angle glaucoma patients over one year, demonstrating a safe and promising new surgical option.
Abstract
Purpose
To report the safety and the effectiveness of deep sclerectomy (DS) with a new nonabsorbable uveoscleral hema implant (Esnoper-Clip) designed to increase trabecular and uveoscleral outflow and to achieve higher intrascleral blebs.
Materials and methods
Twenty-seven eyes of 27 patients with open-angle glaucoma, who underwent DS with an Esnoper-Clip implant, were included in this study. All patients were followed up after 12 months.
Results
A significant decrease in intraocular pressure was observed after surgery, changing from a preoperative mean of 26.6±5.2 mm Hg to a postoperative mean of 15.3±5 mm Hg (P<0.001) at 12 months. There was also a significant reduction in the number of glaucoma drugs needed, varying from 2.5 per patient to 0.3 (P<0.001) 1 year after surgery. The main intrascleral lake height and volume at 12 months was 0.7±0.1 mm and 3.9±1.3 mm, respectively. No intraoperative complications occurred. The main postoperative complications were a positive Seidel test result at 24 hours in 2 eyes (7.4%), hyphema in 2 eyes (7.4%), and choroidal detachment in 1 eye (3.7%). All these complications resolved successfully. The need for additional mitomycin-C injections was recorded in 4 eyes (14.8%), twice in 2 of them. Twelve eyes (44.4%) underwent postsurgical Nd:YAG laser goniopuncture with a mean time between surgery and this procedure of 4.3 months. Mean intraocular pressure after Nd:YAG laser goniopuncture decreased from 19.2 to 15.5 mm Hg (P<0.001).
Conclusion
DS with an uveoscleral hema implant (Esnoper-Clip) is a safe and effective technique for the management of open-angle glaucoma.
MeSH Terms
Shields Classification
Key Concepts4
Deep sclerectomy (DS) with an Esnoper-Clip implant significantly decreased intraocular pressure (IOP) from a preoperative mean of 26.6±5.2 mm Hg to a postoperative mean of 15.3±5 mm Hg (P<0.001) at 12 months in 27 eyes of 27 patients with open-angle glaucoma.
Deep sclerectomy (DS) with an Esnoper-Clip implant significantly reduced the number of glaucoma drugs needed from 2.5 per patient to 0.3 (P<0.001) 1 year after surgery in 27 eyes of 27 patients with open-angle glaucoma.
The main postoperative complications of deep sclerectomy (DS) with an Esnoper-Clip implant in 27 eyes of 27 patients with open-angle glaucoma were a positive Seidel test result at 24 hours in 2 eyes (7.4%), hyphema in 2 eyes (7.4%), and choroidal detachment in 1 eye (3.7%), all of which resolved successfully.
Nd:YAG laser goniopuncture was performed in 12 eyes (44.4%) after deep sclerectomy (DS) with an Esnoper-Clip implant, with a mean time between surgery and this procedure of 4.3 months, resulting in a decrease in mean intraocular pressure from 19.2 to 15.5 mm Hg (P<0.001).
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