Posters

Effects of CO2 laser-assisted deep sclerectomy surgery for primary open-angle glaucoma

Poster Details

First Author: G.Tang CHINA

Co Author(s):    H. Zhang   F. Li   X. Yan   L. Ma   Y. Geng        

Abstract Details

Purpose:

Objective: To assess the clinical effects and safety between CO2 laser-assisted deep sclerectomy surgery (CLASS) and trabeculectomy for the primary open-angle glaucoma (POAG).

Setting:

Department of Glaucoma,The First Hospital of Shijiazhuang City, The First Eye Hospital of Shijiazhuang City,Shijiazhuang, 050000, China

Methods:

Prospective randomized case-control study. A total of 77 eyes of 62 patients with primary open-angle glaucoma consecutively recruited were randomly divided into CLASS group and Trab group. There were 30 eyes of 24 cases in CLASS group which were intervened with CO2 laser-assisted deep sclerectomy surgery. In Trab group, 47 eyes of 38 cases were treated with trabeculectomy. Pre-op difference of baseline parameters were not significant between the groups (P>0.05). The mean follow-up period was 10±2.6months. The visual acuity (VA), intraocular pressure (IOP), bleb morphologic features and complications were compared before and after surgery.

Results:

Post-op VA comparison: in CLASS after 1week full recovery while decrease in Trab(P<0.05); at 1month full recuperation in Trab(P>0.05). Pre-op IOP in CLASS and Trab was 36.42±6.40mmHg and 37.89±4.83mmHg, respectively. Post-op IOP at 1week, 3months and 6months declined to 11.98±2.99mmHg, 14.97±3.30mmHg and 15.19±3.19mmHg in CLASS, and to 12.86±3.18mmHg, 15.98±3.75mmHg and 15.75±2.82mmHg in Trab, respectively. Functional bleb comparison 6months post-op: in CLASS 55.17%, in Trab 82.98% respectively. Success rates in CLASS and in Trab were 86.21% and 80.85% 6months after surgery, respectively(P＞0.05). Post-op complications: in CLASS there were significantly less complications compared to Trab(P<0.05).

Conclusions:

CLASS is an effective and safe treatment for patients with primary open angle glaucoma. The difference in IOP reduction was not statistically significant between the groups(P＞0.05) which means similar efficacy although there was a significant difference in functional bleb between the groups(P<0.05). CLASS showed quicker visual recovery and a significantly higher safety profile(P<0.05): in CLASS only 1eye with superficial ciliary detachment after 4weeks; in Trab 9eyes had shallow anterior chamber, 5eyes had choroidal detachment, 1eye with hyphema and 1eye formed macular cystoid degeneration. In summary CLASS is as effective as Trab but offers a better safety profile.

Financial Disclosure:

None