Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later

Detalhes bibliográficos
Autor(a) principal: Pereira, Sara
Data de Publicação: 2022
Outros Autores: Tenedório, Paula, Gonçalves, Rita, Bastos, Ricardo, Barbosa, Renato
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.48560/rspo.25711
Resumo: INTRODUCTION: Deep sclerectomy is a nonpenetrating glaucoma surgery that presents as an effective option for open angle glaucoma treatment, with an enhanced safety profile than trabeculectomy. In this study, we present the long-term outcomes of deep sclerectomy in open angle glaucoma patients. METHODS: Retrospective analysis of patients with open angle glaucoma submitted to nonpenetrating deep sclerectomy (NPDS) between 2011 and 2017, at Hospital Pedro Hispano. A minimum of 2 years of follow-up was required. Absolute success was defined as postoperative intraocular pressure (IOP) ≤18 mmHg without additional treatment and qualified success as post- operative IOP ≤18 mmHg with or without additional treatment. RESULTS: A total of 76 eyes with primary open angle glaucoma (56 eyes, 73.7%) or pseudo-exfoliative glaucoma (20 eyes, 26.3%) were included in this study. IOP was significantly reduced after surgery (p<0.001), with mean IOP<18 mmHg in all the evaluated follow-up moments (until month 84). Therapeutic success was superior to 90% in in the first 24 months. Absolute success was achieved in 78.4%, 60.7% and 51.2% at 24, 36 and 60 months of follow-up. Qualified success was achieved in 91.6%, 86.9% and 90.2% (24, 36 and 60 months). Additional treatment was re- quired in 33 eyes (43.4%). Postoperatively, the mean number of medications dropped from 2.4 to 0.8 (p<0.05). Postoperative complications were infrequent. CONCLUSION: Nonpenetrating deep sclerectomy is a safe and effective surgical procedure in open angle glaucoma, allowing sustained IOP control over time, allied to a low rate of surgical complications.
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spelling Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes LaterResultados a Longo-Prazo da Esclerectomia Profunda Não-Perfurante: Sete Anos e 70 Olhos DepoisArtigos OriginaisINTRODUCTION: Deep sclerectomy is a nonpenetrating glaucoma surgery that presents as an effective option for open angle glaucoma treatment, with an enhanced safety profile than trabeculectomy. In this study, we present the long-term outcomes of deep sclerectomy in open angle glaucoma patients. METHODS: Retrospective analysis of patients with open angle glaucoma submitted to nonpenetrating deep sclerectomy (NPDS) between 2011 and 2017, at Hospital Pedro Hispano. A minimum of 2 years of follow-up was required. Absolute success was defined as postoperative intraocular pressure (IOP) ≤18 mmHg without additional treatment and qualified success as post- operative IOP ≤18 mmHg with or without additional treatment. RESULTS: A total of 76 eyes with primary open angle glaucoma (56 eyes, 73.7%) or pseudo-exfoliative glaucoma (20 eyes, 26.3%) were included in this study. IOP was significantly reduced after surgery (p<0.001), with mean IOP<18 mmHg in all the evaluated follow-up moments (until month 84). Therapeutic success was superior to 90% in in the first 24 months. Absolute success was achieved in 78.4%, 60.7% and 51.2% at 24, 36 and 60 months of follow-up. Qualified success was achieved in 91.6%, 86.9% and 90.2% (24, 36 and 60 months). Additional treatment was re- quired in 33 eyes (43.4%). Postoperatively, the mean number of medications dropped from 2.4 to 0.8 (p<0.05). Postoperative complications were infrequent. CONCLUSION: Nonpenetrating deep sclerectomy is a safe and effective surgical procedure in open angle glaucoma, allowing sustained IOP control over time, allied to a low rate of surgical complications.INTRODUçÃO: A esclerectomia profunda é uma cirurgia não-penetrante e é uma opção eficaz no tratamento do glaucoma de ângulo aberto, com um melhor perfil de segurança relativamente à trabeculectomia. Neste trabalho, os autores apresentam os resultados a longo-prazo da esclerectomia profunda em pacientes com glaucoma de ângulo aberto. MÉTODOS: Análise retrospetiva de pacientes com glaucoma de ângulo aberto submetidos a esclerectomia profunda não-perfurante (EPNP) entre 2011 e 2017, no Hospital Pedro Hispano. Um follow-up mínimo de 2 anos foi necessário para a análise. Sucesso absoluto foi definido como pressão intraocular (PIO) pós-operatória ≤18 mmHg, sem necessidade de tratamento adicional, e o sucesso relativo foi definido como PIO pós-operatória ≤18 mmHg, com ou sem tratamento adicional. RESULTADOS: Um total de 76 olhos foram incluídos neste estudo (56 olhos, 73,7%, com glaucoma primário de ângulo aberto e 20 olhos, 26,3%, com glaucoma pseudoesfoliativo). A PIO foi significativamente reduzida após a cirurgia (p<0,001), com PIO média<18 mmHg em todos os momentos de follow-up avaliados (até ao mês 84). O sucesso terapêutico foi superior a 90% nos primeiros 24 meses. Sucesso absoluto foi atingido em 78,4%, 60,7% e 51,2% aos meses 24, 36 e 60 de seguimento. Sucesso relativo foi atingido em 91,6%, 86,9% e 90,2% (aos 24,36 e 60 meses). Tratamento adicional foi necessário em 33 olhos (43,4%). No pós-operatório, o número médio de fármacos hipotensores diminuiu de 2,4 para 0,8 (p<0,05). Foram registadas escassas complicações pós-operatórias. CONCLUSÃO: A EPNP é um procedimento cirúrgico seguro e eficaz no glaucoma de ângulo aberto, permitindo um controlo sustentado da PIO ao longo do tempo, aliado a uma baixa taxa de complicações cirúrgicas.Ajnet2022-12-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.48560/rspo.25711eng1646-69501646-6950Pereira, SaraTenedório, PaulaGonçalves, RitaBastos, RicardoBarbosa, Renatoinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-01-12T20:30:15Zoai:ojs.revistas.rcaap.pt:article/25711Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:29:29.480970Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
Resultados a Longo-Prazo da Esclerectomia Profunda Não-Perfurante: Sete Anos e 70 Olhos Depois
title Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
spellingShingle Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
Pereira, Sara
Artigos Originais
title_short Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
title_full Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
title_fullStr Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
title_full_unstemmed Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
title_sort Long-Term Results of Nonpenetrating Deep Sclerectomy: Seven Years and 70 Eyes Later
author Pereira, Sara
author_facet Pereira, Sara
Tenedório, Paula
Gonçalves, Rita
Bastos, Ricardo
Barbosa, Renato
author_role author
author2 Tenedório, Paula
Gonçalves, Rita
Bastos, Ricardo
Barbosa, Renato
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Pereira, Sara
Tenedório, Paula
Gonçalves, Rita
Bastos, Ricardo
Barbosa, Renato
dc.subject.por.fl_str_mv Artigos Originais
topic Artigos Originais
description INTRODUCTION: Deep sclerectomy is a nonpenetrating glaucoma surgery that presents as an effective option for open angle glaucoma treatment, with an enhanced safety profile than trabeculectomy. In this study, we present the long-term outcomes of deep sclerectomy in open angle glaucoma patients. METHODS: Retrospective analysis of patients with open angle glaucoma submitted to nonpenetrating deep sclerectomy (NPDS) between 2011 and 2017, at Hospital Pedro Hispano. A minimum of 2 years of follow-up was required. Absolute success was defined as postoperative intraocular pressure (IOP) ≤18 mmHg without additional treatment and qualified success as post- operative IOP ≤18 mmHg with or without additional treatment. RESULTS: A total of 76 eyes with primary open angle glaucoma (56 eyes, 73.7%) or pseudo-exfoliative glaucoma (20 eyes, 26.3%) were included in this study. IOP was significantly reduced after surgery (p<0.001), with mean IOP<18 mmHg in all the evaluated follow-up moments (until month 84). Therapeutic success was superior to 90% in in the first 24 months. Absolute success was achieved in 78.4%, 60.7% and 51.2% at 24, 36 and 60 months of follow-up. Qualified success was achieved in 91.6%, 86.9% and 90.2% (24, 36 and 60 months). Additional treatment was re- quired in 33 eyes (43.4%). Postoperatively, the mean number of medications dropped from 2.4 to 0.8 (p<0.05). Postoperative complications were infrequent. CONCLUSION: Nonpenetrating deep sclerectomy is a safe and effective surgical procedure in open angle glaucoma, allowing sustained IOP control over time, allied to a low rate of surgical complications.
publishDate 2022
dc.date.none.fl_str_mv 2022-12-30
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