Erbium:YAG laser deep sclerectomy:: An alternative approach to glaucoma surgery

BACKGROUND AND OBJECTIVES: To study and evaluate, prospectively, the effectiveness and the safety of deep sclerectomy when it is performed with the assistance of the erbium:YAG laser in eyes with primary open-angle glaucoma. PATIENTS AND METHODS: Forty eyes of 40 patients with primary open-angle glaucoma or pseudoexfoliative glaucoma were enrolled consecutively to undergo laser deep sclerectomy. Mitomycin C (0.2 mg/mL for 2.5 minutes) was also used before the superficial scleral flap formation. The follow-up was 24 months for all patients. RESULTS: The intraocular pressure was significantly decreased by 9.15 mm Hg or 35.1% (from 26.05 +/- 2.55 to 16.9 +/- 3.45 mm Hg) at the end of the follow-up period. The complete and qualified success rates at the end of the follow-up period were 37.5% and 62.5%, respectively. Mild complications such as choroidal detachment, hyphema, and leakage were observed. CONCLUSIONS: The use of the erbium:YAG laser for performing a deep sclerectomy procedure seems to be a safe and relatively effective alternative to the conventional surgical procedure. Further studies and longer follow-up are necessary for the evaluation of the efficacy of this technique.