Posters

Long-term results of non-penetrating deep sclerectomy with Esnoper V-2000 implant in a tertiary centre of ophthalmology in Portugal

Poster Details

First Author: C.Xavier PORTUGAL

Co Author(s):    N. Moura-Coelho   M. Boncquet Vieira   T. Gomes   J. Lisboa           

Abstract Details

Purpose:

To report the long-term efficacy and safety of non-penetrating deep sclerectomy (NPDS) with adjunctive mitomycin C (MMC) and a nonabsorbable hydroxyethyl methacrylate implant (Esnoper V2000) in our institution.

Setting:

Tertiary hospital in Lisbon, Portugal, a referral center for glaucoma surgery nationwide.

Methods:

Retrospective study. Inclusion criteria: adjunctive use of MMC and Esnoper V2000; follow-up time post-NPDS≥24 months; absence of additional glaucoma surgery within the first 24 months post-NPDS. Of 55 NPDS surgeries performed between April 2013 and January 2017 in our institution, 39 eyes (35 patients) met the inclusion criteria. Primary outcome was surgical success, defined as intraocular pressure (IOP) at last follow-up observation ≤18mmHg and IOP reduction rate (IOP-RR)≥20%, either with (relative) or without (absolute) need of IOP-lowering drugs, and without additional surgery.Secondary outcomes were change in number of antihypertensive drugs, goniopuncture rate, and need for additional glaucoma surgery.

Results:

Mean patient age at NPDS was 69.0(±11.3) years. Mean pre-NPDS IOP was 21.6(±6.0)mmHg on median 4(1) drugs. Mean follow-up time post-NPDS was 40.3(±14.2) months. Statistically significant reductions in median IOP and IOP-lowering drugs were observed at 2-year (M24) and last follow-up compared to baseline (p<0.001). Median final IOP was 14.0(6.0) mmHg, a non-statistically significant change from M24 (p=0.491), on a median number of 1(2) drugs. Success rate was 61.5% (25.6% absolute, 35.9% relative success). Goniopuncture rate was 35.9%, performed at a mean time of 14.4 (±6.5) months post-NPDS. Two eyes(5.1%) needed additional glaucoma surgery after M24.

Conclusions:

In our study, NPDS with adjunctive MMC and Esnoper resulted in a significant reduction in IOP and number of IOP-lowering drugs over the long term, with a relatively high surgical success rate. The need of goniopuncture appears to be higher within the first 2 years of surgery, and the need for additional glaucoma surgery is low in NPDS eyes.

Financial Disclosure:

None