Deep sclerectomy in patients with capsular glaucoma

Abstract

Purpose: To compare the results of deep sclerectomy in capsular glaucoma (CG) with those in primary open-angle glaucoma (POAG). Methods: This consecutive, prospective study comprised 24 CG patients (28 eyes) and 25 POAG patients (29 eyes) who underwent deep sclerectomy. Two different implants were used: either an absorbable collagen implant (Aqua-Flow®) or a non-absorbable hydrophilic acrylic implant (T-Flux®). The number of glaucoma medications, intraocular pressure (IOP) and complications were compared postoperatively. The definition of complete success was IOP below 19 mmHg without therapy. Results: After a mean follow-up of 19.9 ± 10.9 months (range 6-36 months) in the CG group and 16.2 ± 10.0 months (range 6-36 months in the POAG group, complete success was seen in 60.7% and in 37.9% of eyes, respectively (p = 0.085). After adjustments for disparities in baseline characteristics, survival analysis demonstrated that success rates were better over time in CG eyes than in POAG eyes (p = 0.038). At all time-points, except at 24 months, the IOP was lower in the CG group than in the POAG group. This difference was statistically significant at 1 week (p = 0.050) and 3 months (p = 0.006). At 18 months, the mean decrease in number of medications was 77.3% in the CG group and 65.9% in the POAG group (not statistically significant). Levelled hyphema occurred more frequently in CG eyes (35.7%) than in POAG eyes (13.8%). Conclusion: Capsular glaucoma patients had significantly higher success rates over time than POAG patients following deep sclerectomy with implant.