Non-penetrating deep sclerectomy without or with autologous scleral implant in open-angle glaucoma: medium-term results

Background: This study compares the medium-term success rate and complications of non-penetrating deep sclerectomy (NPDS) without and with autologous scleral implant in open-angle glaucoma. Methods: Retrospective review of 93 eyes of 93 patients with medically uncontrolled open-angle glaucoma who underwent NPDS without (n=69, group 1) or with (n=24, group 2) autologous scleral implant. Results: The mean follow-up was 16 months (range 5-36) in group 1 and 15 months (range 4-28) in group 2. The mean intra-ocular pressures (IOP) pre- and postoperatively were, respectively, 23.8 and 16.1 mmHg in group 1, and 25.6 and 15.8 mmHg in group 2. The absolute success rate was 41% in group 1 and 54% in group 2. The qualitative success rate was 83% in group 1 and 75% in group 2. An IOP lower than 16 mmHg was obtained in 51% of patients in group 1 and 58% of patients in group 2. A Nd:YAG laser goniopuncture was performed in 30% of patients in group 1 and 50% of patients in group 2, and resulted in a better controlled IOP. Conclusions: NPDS without or with an autologous scleral implant is a safe procedure reducing the IOP significantly, but probably not sufficient when an IOP below 16 mmHg is required. We found no statistically significant difference between the two groups.