POST-OP MANAGEMENT IN DEEP SCLERECTOMY AND THE BEST OUTCOME OF SURGERY: THE FIRST MONTH

F. Vigasio, R. Bellucci, M. Bertelli and M. Cassamali

Ophthalmic Unit-Hospital of Desenzano, Italy

Introduction:One of the claimed advantages of deep sclerectomy (DS) is the reduction of office visits after surgery thanks to the low incidence of pos-op complications. However in our previous experiences we observed that in the first month careful monitoring of intraocular pressure (IOP) is necessary for the best outcome of surgery. Purpose: To report how to optimise IOP control in eyes with primary open angle-glaucoma by DS in the first post-op month. Methods: 53 open angle-glaucoma patients with uncontrolled IOP underwent DS without implant as a single procedure or as a part of a combined operation. A standard post-op regimen withtopical steroids and antibiotics was employed. A complete ophthalmologic examination was performed post-op on days 1,7,14 and 28. Results: In the first post-op month, in 9 eyes we had to switch to non steroidal anti-inflammatory (NSAI) drugs due to steroid-induced ocular hypertension; in 4 eyes we performed Nd:YAG laser-goniopunctures; in 1 eye we used 5-FU; in 1 eye we prescribed a glaucoma medication. Conclusions: DS is a safe procedure still investigated in term of long term efficacy. A scrupulous postoperative management is mandatory for the best outcome of surgery.