Efficacy and safety of non-penetrating deep sclerectomy surgery in Saudi patients with uncontrolled open angle glaucoma

OBJECTIVE: To investigate the efficacy and safety of deep sclerectomy (DS) in Saudi patients with primary and secondary open-angle glaucoma (OAG).

METHODS: In this retrospective cohort study, a total of 194 eyes of 152 patients with OAG were consecutively enrolled to undergo DS with Mitomycin-C (MMC) at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia between January 2002 and September 2010. Age at surgery, gender, type of glaucoma, operated eye, previous ocular surgery, type of implant, pre and final visit visual acuities, intraocular pressure (IOP), number of anti-glaucoma medications, optic nerve cup/disc ratio, and complications were recorded.

RESULTS: Cases were followed up to a mean of 60.9 (+/-49.7) months. The IOP reduced from a preoperative mean of 25.6 (+/-10.3) to final visit of 13.5 (+/-4), whereas the mean number of anti-glaucoma medication also reduced from 2.95 (+/-0.93) to 0.22 (+/-0.63), which was statistically significant (p<0.0001). Complete success was 82%, while overall success was 90.2%. Patients <50 years (p=0.003), high IOP (>/=21) at baseline (p=0.039), and being exposed to previous surgeries (p=0.047) were significant risk factors for failure, while combining cataract and converting to penetrating surgery have significantly improved the success rate (p=0.037).

CONCLUSION: Deep sclerectomy provides significant IOP reduction with low rate of visual threatening complications in Saudi patients with open angle glaucoma.