Ultrasound biomicroscopy and intraocular-pressure-lowering mechanisms of deep sclerectomy with reticulated hyaluronic acid implant

Journal of Cataract and Refractive Surgery
G MarchiniL Bonomi

Abstract

To evaluate the anatomic characteristics and intraocular pressure (IOP) lowering mechanisms of deep sclerectomy with reticulated hyaluronic acid implant (DS with RHAI) using ultrasound biomicroscopy (UBM). Eye Clinic, Department of Neurological and Vision Sciences, University of Verona, Verona, Italy. Thirty patients with primary open-angle glaucoma not controlled by medical therapy had DS with RHAI in 1 eye. A complete ocular examination and UBM study were performed 1, 3, 6, and 12 months postoperatively and thereafter at 6 month intervals. Eleven parameters were evaluated, the most important of which were IOP, surgical success in lowering IOP to 21 mm Hg or less with or without additional medical therapy, UBM appearance of the site of DS with RHAI, size of the decompression space, presence of a filtering bleb and supraciliary hypoechoic area, and scleral reflectivity around the decompression space. After a mean follow-up of 11.4 months +/- 4.7 (SD), the mean percentage reduction in IOP compared to preoperatively was 38% (from 26 +/- 4.5 mm Hg to 16.2 +/- 3.8 mm Hg; P =.0001). Twenty-four patients (80%) had an IOP less than 21 mm Hg; however, 7 of these eyes (23%) required additional IOP-lowering medical therapy. The operation...Continue Reading

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