Augmentation of Filtering Blebs with Viscoelastics in Trabeculectomy.
10.3341/kjo.2014.28.5.393
- Author:
Hyerin JEONG
1
;
Kyung Rim SUNG
Author Information
1. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sungeye@gmail.com
- Publication Type:Comparative Study ; Original Article
- Keywords:
Anti-fibrotic agent;
Glaucoma;
Hyaluronic acid;
Trabeculectomy;
Viscoelastics
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Child;
Combined Modality Therapy;
Female;
Follow-Up Studies;
Glaucoma/*surgery;
Humans;
Hyaluronic Acid/*therapeutic use;
Intraocular Pressure/physiology;
Male;
Middle Aged;
Tonometry, Ocular;
Trabeculectomy/*methods;
Viscosupplements/*therapeutic use
- From:Korean Journal of Ophthalmology
2014;28(5):393-398
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the clinical outcome of viscoelastics (VE, sodium hyaluronate)-augmented trabeculectomy (VAT, 66 eyes) and conventional trabeculectomy (CT, 57 eyes) for glaucomatous eyes. METHODS: In the VAT group, half of the anterior chamber space was filled with VE via the paracentesis site at the end of CT and a balanced salt solution was injected into the anterior chamber. This procedure induced migration of VE from the anterior chamber into the bleb space; thus the bleb was elevated with underlying VE. Follow-up examinations were performed until 1 year after surgery. Success was defined as the attainment of an intraocular pressure (IOP) greater than 5 mmHg and less than 22 mmHg. If IOP was in the range of success without antiglaucoma medication, it was regarded as a complete success. RESULTS: The mean postoperative IOP was significantly lower in the VAT group at postoperative 1 day, 1 week, and 1 month. The complete success rate was significantly higher in the VAT group (89%) than in the CT group (75%), though the qualified success rate was not different between the two groups. The number of IOP-lowering medications at postoperative 1 year was significantly higher in the CT group (1.30 ± 1.08 vs. 0.73 ± 0.98, p = 0.003). Among postoperative procedures, laser suture lysis was required less frequently in the VAT group (p < 0.001). CONCLUSIONS: Placing VE within the bleb at the end of surgery may result in better IOP control and less need for IOP-lowering medication without any additional materials, cost, or time.
