Purpose: To prospectively compare the results of Deep sclerectomy(DS) versus deep sclerectomy with collagen implant(DSCI)
Methods: Randomised prospective trial involving 104 eyes (104 patients) with medically uncontrolled primary and secondary open angle glaucoma. All patients had DS, half of them with, and the other half without a collagen implant.
Results: Mean follow-up period was 44.04 (SD 21) months for the DS group, and 43.97(SD 14) months for the DSCI group. The mean preoperative IOP was 23.4(SD 7.2)mmHg for the DS group, and 25.6(SD 4.9)mmHg for the DSCI group. The mean IOP at the first postoperative day was 6.1(SD 4.21) mmHg for the DS group, and 5.1 (SD 3.3) mmHg for the DSCI group. At 48 months IOP was reduced by 40% (14 versus 23.3 mmHg) for the DS group, and was reduced by 50% (12.7 versus 25.6 mmHg). Complete success rate, defined as IOP lower than 21 mmHg without medication, was 34.6 % (18/52 patients) at 48 months for the DS group, and 63.4 % (33/52 patients) for the DSCI group. Qualified success rate; patients who achieved IOP below 21 mmHg with or without medication, was 78.8 % (41/52 patients) at 48 months and 94 % (49/52 patients) for the DSCI group. Mean number of medications was reduced from 2.1(SD 0.8) to 1(SD 1) after DS, and was reduced from 2.2(SD 0.7) to 0.4(SD 0.6) in the DSCI group(P=0.001)
Conclusion: The use of a Collagen implant in DS seems to enhance the success rates and lower the need for postoperative medications.