Reverse cyclodialysis and implantation of a novice stainless steel supraciliary implant in management of open-angle glaucoma in cataract patients

Session Details

Session Title: Cataract Surgery & Glaucoma

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 14:40

Venue: Room A3, Podium 1

First Author: : A.Shradqa RUSSIA

Co Author(s): :    V. Kumar   M. Frolov   G. Dushina   A. Bezzabotnov           

Abstract Details

Purpose:

To evaluate the safety and effectiveness of reverse cyclodialysis and implantation of a novice stainless steel supraciliary implant in decreasing intraocular pressure (IOP) and hypotensive medication(s) use in patients with concomitant pathology.

Setting:

Ophthalmic unit of Skhodnya city hospital, Moscow province; Department of Ophthalmology Medical Institute People's friendship university of Russia, Moscow, Russia.

Methods:

Twenty-two patients (14 male and 8 female, average age - 73.5+5.3 yrs) suffering from cataract and glaucoma were operated upon. After cataract surgery, a specially designed cyclodialysis spatula was inserted through main incision and ciliary body was gently detached from sclera creating a cleft of 2,5mm wide and 6-6,5mm deep. In 14 cases an original stainless steel implant was implanted in the supraciliary space (implant group). Other eight cases served as control. Outcome measures were IOP change, use of hypotensive medication(s) and complications. Success rates were evaluated using World Glaucoma Association’s guidelines. Results were significant when p <.05.

Results:

Baseline IOP and hypotensive medication use in implant group was 22.2±5.7mmHg and 2.4±.9; in control group - 22.4±7.3mmHg and 2.5±.5. At 12 months IOP reduced in implant group by 47.9+13.1% and was 10.9±1mmHg (p=1E-05). In control group, it was reduced by 44+24.1% and was 10.6+1.7 mmHg (p=.009). Use of hypotensive medications reduced to 0,8 ±1,1 (p=.002) in implant group and to .9±1.1 (p=.0053) in control group. Complete success cases were more in implant group (57.1% versus 37.5%, p=.044). There was 1 failure case in each group (p=.22).Intra- and post-operative complication observed was bleeding and hyphema.

Conclusions:

Ab interno reverse cyclodialysis with or without implantation of supraciliary metallic implant was safe and effective in decreasing IOP in patients suffering from concomitant pathology. However, implantation of metallic supraciliary implant helps in further reduction of patient's dependency on use of hypotensive medication(s) to control IOP after cataract surgery.

Financial Disclosure:

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