Five-year results of non-penetrating deep sclerectomy with demineralized cancellous bone xenogenically derived collagen glaucoma implant

Purpose

To investigate the long-term effectiveness of non-penetrating deep sclerectomy (NPDS) with xenogenically derived cancellous bone collagen glaucoma implant (XCB-CGI) implantation in patients with primary open-angle glaucoma (POAG).

Materials and methods

Retrospective chart review of patients with POAG stages 2 and 3 was treated with NPDS and XCB-CGI. Follow-up was at 6 months, 1, 2, 3, 4 and 5 years after surgery. Main outcomes were intraocular pressure (IOP) and medication burden. Secondary outcomes were visual acuity, corneal hysteresis (CH), visual field (VF) and optical coherence tomography (OCT) parameter analysis.

Results

Among 71 patients (71 eyes), the mean age was 72.7?±?9.8. Average initial IOP was 27.7?±?7.9 and average initial med load was 2.36?±?0.99. At 6 months, 1, 2, 3, 4 and 5 years, the average IOP was 14.9?±?3.3 mm Hg (46.2% reduction), 15.3?±?4.0 mm Hg (44.7% reduction), 14.2?±?3.8 mm Hg (48.7% reduction), 15.2?±?3.3 mm Hg (45.0% reduction), 15.5?±?3.3 mm Hg (44.0% reduction) and 14.2?±?2.8 mm Hg (48.7% reduction), respectively. In 5 years, the success rate was 34% and 67%, without, and with medications (1.8?±?0.8 meds required), respectively. Visual acuity was not significantly different (P?>?.05) at all follow-up visits from baseline. Mean CH increased by 2.1?±?0.8 (P?=?.05). No glaucomatous deterioration of the VF and OCT parameters was detected in 56 eyes at the 5-year follow-up.

Conclusion

NPDS with XCB-CGI implantation is an effective procedure to normalize the level of IOP, stabilize glaucomatous changes and decrease the number of meds needed for glaucoma control.