Nonpenetrating Deep Sclerectomy for Progressive Glaucoma: Long-term (5-year) Follow-up of Intraocular Pressure Control and Visual Field Survival.

ABSTRACT

PURPOSE: To monitor 5-year outcomes of nonpenetrating deep sclerectomy (NPDS) with mitomycin C (MMC) in a new consecutive patient cohort. MATERIALS AND METHODS: All eyes undergoing NPDS surgery between 1/08 and 6/12 were monitored for intraocular pressure (IOP), number of antiglaucoma medications (meds), and visual field indices [mean deviation (MD) and corrected pattern standard deviation (CPSD)], relative to the preoperative baseline using the two-tailed paired Student's t test. RESULTS: Of 106 eyes undergoing NPDS with MMC, mean IOP was 19.7 ± 0.5 [sem] mm Hg preoperatively, 11.9 ± 0.5 at 3 months, 12.5 ± 0.6 at 6 months, 12.4 ± 0.5 at 12 months, 12.6 ± 0.6 at 18 months, 11.1 ± 0.6 at 2 years, 11.8 ± 0.5 at 2.5 years, 11.0 ± 0.5 at 3 years, 11.7 ± 0.5 at 3.5 years, 10.7 ± 0.7 at 4 years, 11.6 ± 0.5 at 4.5 years, and 12.4 ± 0.7 at 5 years (average IOP reduction of 7.8 mm Hg or 37%; p < 10-6) at 5 years. About 92% of eyes had stable IOP ≥5 and ≤21 mm Hg at 5 years. Mean preoperative meds 2.7 ± 0.1 was reduced to 0.40 ±0.09 at 3 months, 0.51 ± 0.1 at 6 months, 0.38 ± 0.08 at 12 months, 0.49 ± 0.09 at 18 months, 0.41 ± 0.09 at 2 years, 0.39 ± 0.09 at 2.5 years, 0.49 ± 0.1 at 3 years, 0.58 ± 0.1 at 3.5 years, 0.49 ± 0.1 at 4 years, 0.64 ± 0.1 at 4.5 years, and 0.52 ± 0.1 at 5 years, corresponding to mean reduction of 2.2 meds (81%; p < 10-22) at 5 years. Mean deviation and CPSD were stable relative to baseline at all time intervals (R = 0.83-0.94; p < 0.0001). CONCLUSION: With appropriate postoperative management, eyes undergoing NPDS can maintain excellent IOP control with minimal medication use and maintain very stable visual fields over an extended time frame. HOW TO CITE THIS ARTICLE Slagle G, Groth SL, Montelongo M, et al. Nonpenetrating Deep Sclerectomy for Progressive Glaucoma Long-term (5-year) Follow-up of Intraocular Pressure Control and Visual Field Survival. J Curr Glaucoma Pract 2020;14(1)3-9.