DEEP SCLERECTOMY - RESULTS WITH AND WITHOUT COLLAGEN IMPLANT

Purpose: To study the need, the safety and the success rate of collage n implant in eyes that underwent deep sclerectomy, a new non penetrati ng filtration procedure, we compared the results of deep sclerectomy w ith (DSCI) and without (DS) collagen implant. Methods: Of 168 patients (168 eyes) with various types of medically uncontrolled open angle gl aucoma, 86 (86 eyes) underwent DSCI, and 82 (82 eyes) underwent DS. Vi sual acuity, slit lamp examination, intraocular pressure (IOP) measure ments were performed before surgery and prospectively at days 1 and 7 and months, 1, 2, 3, 6, 9, 12, 15, 18, and 24 after surgery. Deep scle rectomy was performed according to Kozlov's original technique. The co llagen implant drainage device was radially secured in the center of t he deep sclerectomy dissection. Results: The mean follow-up period was 9.7 +/- 6.5 months for DSCI, and 9.0 +/- 4.8 months for DS. The mean preoperative IOP was 26.9 +/- 8.8 mmHg for DSCI and 25.8 +/- 8.5 mmHg for DS. The mean postoperative IOP and visual acuity were similar betw een the two groups. Complete and qualified success rates were better w hen the collagen implant was used (Log-Rank test: p = 0.0002 and 0.033 for complete and qualified success respectively). The need for postop erative glaucoma medications was significantly lower when the collagen implant was used (0.2 +/- 0.5 versus 0.5 +/- 0.7 medication per patie nt in the DSCI and DS respectively, Student's t test: p = 0.0038). The re was significantly less bleb fibrosis when the collagen implant was used (2% and 11% in DSCI and DS respectively, p = 0.029). Conclusion: The collagen implant device is safe, increases the success rate of dee p sclerectomy, and lowers the need for postoperative glaucoma medicati ons.