Deep Sclerectomy With a New Nonabsorbable Uveoscleral Implant (Esnoper-Clip): 1-Year Outcomes.

Abstract

PURPOSE:

To report the safety and the effectiveness of deep sclerectomy (DS) with a new nonabsorbable uveoscleral hema implant (Esnoper-Clip) designed to increase trabecular and uveoscleral outflow and to achieve higher intrascleral blebs.

MATERIALS AND METHODS:

Twenty-seven eyes of 27 patients with open-angle glaucoma, who underwent DS with an Esnoper-Clip implant, were included in this study. All patients were followed up after 12 months.

RESULTS:

A significant decrease in intraocular pressure was observed after surgery, changing from a preoperative mean of 26.6±5.2 mm Hg to a postoperative mean of 15.3±5 mm Hg (P<0.001) at 12 months. There was also a significant reduction in the number of glaucoma drugs needed, varying from 2.5 per patient to 0.3 (P<0.001) 1 year after surgery. The main intrascleral lake height and volume at 12 months was 0.7±0.1 mm and 3.9±1.3 mm, respectively. No intraoperative complications occurred. The main postoperative complications were a positive Seidel test result at 24 hours in 2 eyes (7.4%), hyphema in 2 eyes (7.4%), and choroidal detachment in 1 eye (3.7%). All these complications resolved successfully. The need for additional mitomycin-C injections was recorded in 4 eyes (14.8%), twice in 2 of them. Twelve eyes (44.4%) underwent postsurgical Nd:YAG laser goniopuncture with a mean time between surgery and this procedure of 4.3 months. Mean intraocular pressure after Nd:YAG laser goniopuncture decreased from 19.2 to 15.5 mm Hg (P<0.001).

CONCLUSION:

DS with an uveoscleral hema implant (Esnoper-Clip) is a safe and effective technique for the management of open-angle glaucoma.

• Authors: Jordi Loscos-Arenas, Angels Parera-Arranz, Pau Romera-Romera, Jordi Castellvi-Manent, Antoni Sabala-Llopart, Julio de la Cámara-Hermoso
• Journal: Journal of glaucoma (J Glaucoma) Vol. 24 Issue 6 Pg. 421-5 (Aug 2015) ISSN: 1536-481X [Electronic] United States
• PMID: 25836660 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Methacrylates
• hydroxyethyl methacrylate

Topics

• Aged
• Aqueous Humor (metabolism)
• Female
• Glaucoma, Open-Angle (physiopathology, surgery)
• Humans
• Intraocular Pressure (physiology)
• Intraoperative Complications
• Lasers, Solid-State
• Male
• Methacrylates
• Postoperative Complications
• Prostheses and Implants
• Prosthesis Implantation
• Sclera (metabolism, surgery)
• Sclerostomy (methods)
• Tonometry, Ocular
• Treatment Outcome
• Uvea (metabolism, surgery)