Deep sclerectomy with collagen implant in patients with glaucoma and high myopia.

PURPOSE

To study prospectively the success rate and complications of deep sclerectomy with collagen implant (DSCI), a nonpenetrating filtration procedure, in patients with glaucoma and high myopia.

SETTING

Glaucoma Unit, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland.

METHODS

This nonrandomized prospective trial comprised 21 eyes of 21 highly myopic patients with medically uncontrolled primary or secondary open-angle glaucoma. Visual acuity, intraocular pressure (IOP), and slitlamp examinations were performed before as well as 1 and 7 days and 1, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 54, 60, and 66 months postoperatively. Visual field examinations were repeated every 6 months. Exclusion criteria were known allergy to collagen, advanced lens opacity, and eye surgery or laser trabeculoplasty fewer than 6 months before enrollment.

RESULTS

The mean follow-up was 44.0 months +/- 17.1 (SD). The mean preoperative IOP of 26.4 +/- 5.9 mm Hg dropped to 10.4 +/- 6.1 mm Hg at 48 months. Eighty-one percent of patients achieved an IOP below 21 mm Hg with or without medication at 48 months. Thirty-eight percent had an IOP below 21 mm Hg without medication. The mean number of medications per patient was reduced from 2.30 +/- 0.85 to 0.86 +/- 0.91.

CONCLUSIONS

Deep sclerectomy with collagen implant provided reasonable control of IOP in patients with glaucoma and high myopia over a long-term follow-up. There were relatively few postoperative complications.