Laser goniopuncture is a complementary adjunct to nonfiltering glaucoma surgery such as deep sclerectomy, viscocanalostomy, and canaloplasty, contributing to intraocular pressure control and the avoidance of additional incisional surgery. Goniopuncture is associated with a low complication rate and demonstrates minimal inflammation, hemorrhage, and hypotony when performed correctly. This article provides a detailed description of how to perform this procedure and methods of preventing and addressing complications.
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Outcomes of non-penetrating deep sclerectomy combined with mitomycin C in advanced open-angle glaucoma in Indian eyes.
Indian J Ophthalmol
December 2024
Department of Glaucoma Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Purpose: To assess the safety and efficacy of non-penetrating deep sclerectomy (NPDS) in advanced open-angle glaucoma patients.
Design: Retrospective observational study.
Methods: Forty-two eyes of 38 patients with advanced glaucoma who underwent NPDS surgery combined with mitomycin-C with or without phacoemulsification were evaluated for up to 12 months at a tertiary eye care center in South India.
Reversal of severe myopia by 24 years of hypotony with subsequent stable refraction after 2 years of normal intraocular pressure.
Am J Ophthalmol Case Rep
March 2024
Robert Larner College of Medicine, University of Vermont, Burlington, VT, USA.
Purpose: To report sustained axial length shortening and hyperopic shift (refraction changed from -8 to -2 diopters) induced by 24 years of profound IOP (intraocular pressure) reduction with subsequent refractive stability 2 years after IOP rose to 11-17 mm Hg.
Observations: A 25-year-old woman with elevated episcleral venous pressure glaucoma underwent non-penetrating trabeculectomy and subsequent laser goniopuncture in her left eye. She had chronically low IOP (1-12 mm Hg) for the next 24 years.
Efficacy and safety of deep sclerectomy with uveoscleral implant plus collagen matrix implant overcoming the superficial scleral flap in glaucoma surgery.
Int J Ophthalmol
November 2023
Department of Ophthalmology, Hospital Germans Trias i Pujol, Badalona 08916, Spain.
Aim: To assess the efficacy and safety of non-penetrating deep sclerectomy (NPDS) with uveoscleral implant plus subconjunctival and intrascleral collagen matrix overcoming the superficial scleral flap lips (modified deep sclerectomy technique, DS) and minimal use of mitomycin C in glaucoma surgery.
Methods: A retrospective review of 47 consecutive glaucoma patients who underwent NPDS with DS between January 2017 and May 2018. Best-corrected visual acuity, intraocular pressure (IOP), post-operative need for glaucoma medications, visual field mean deviation (MD), re-interventions, needling revisions and laser goniopuncture were noted.
Results of a modified ab-external trabeculectomy surgical technique in patients with open angle glaucoma.
Arch Soc Esp Oftalmol (Engl Ed)
November 2023
Ophtalmologist, Glaucoma Subspecialist, Private Practice, Visual Sense, Mexico City, México.
Objective: Assess the safety and efficacy of a Modified Ab-externo Trabeculectomy surgical technique in controlling intraocular pressure (IOP) in open-angle glaucoma patients.
Methods And Analysis: Patients diagnosed with primary or secondary open-angle glaucoma underwent this modified technique as the first filtering surgical treatment were included. The preoperative and final follow-up assessed IOP, hypotensive medications, the need for additional treatments, and early and late complications.
Our Experience of Deep Sclerectomy at a Tertiary Center in the United Kingdom Over 14 Years.
Cureus
August 2023
Ophthalmology, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR.
Background Deep sclerectomy (DS) is a non-penetrating surgical procedure for glaucoma, reducing the resistance to aqueous outflow and lowering intraocular pressure while maintaining a physiological barrier between the anterior chamber and the sub-scleral space. This offers a lower complication profile than penetrating procedures, though with less intraocular pressure (IOP) reduction. Methods We retrospectively reviewed the electronic record for all DS undertaken at our hospital (a tertiary care center) over 14 years, collecting data on demographics, diagnosis, IOP, visual acuity, complications, medications, and further procedures required.
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