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Vergleich von resorbierbaren und nichtresorbierbaren skleralen Implantaten bei tiefer Sklerektomie (SK-Gel und T-Flux)

A comparison between absorbable and non-resorbable scleral implants in deep sclerectomy (T-Flux and SK-Gel)

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Zusammenfassung

Hintergrund

Der Einfluss von zwei unterschiedlichen skleralen Platzhaltern (T-Flux und SK-Gel) auf die Augeninnendruck senkende Wirkung der tiefen Sklerektomie teils in Kombination mit Kataraktoperation wurde untersucht.

Patienen und Methode

72 Patienten wurden in diese retrospektive Studie eingeschlossen. Dabei handelte es sich um Glaukompatienten, deren individueller Zieldruck medikamentös nicht erreicht werden konnte. Alle Patienten erhielten eine tiefe Sklerektomie als Druck senkende Operation. Es wurden 13 Patienten mit einem SK-Gel Implantat versorgt, 5 Patienten erhielten ein SK-Gel-Implantat kombiniert mit Kataraktoperation, 31 Patienten wurden sklerale T-Flux-Platzhalter implantiert, 23 Patienten erhielten T-Flux-Implantate kombiniert mit Katraktoperation. Die Patientenuntersuchungen erfolgten direkt prä- und postoperativ sowie nach 12 Monaten.

Ergebnisse

IOD prä OP: 18,4±5,5 mmHg (n=72) und IOD 12 Monate post OP: 13,1±3,8 mmHg (n=65). Anzahl der lokalen Antiglaukomatosa: prä OP 2,3±1,3 (n=72) und 12 Monate post OP: 0,2±0,6 mmHg (n=65). Druck senkende Folge-OP nach 12 Monaten bei insgesamt 15,3% der operierten Augen und konsekutive YAG-Laser-Goniopunctures (insgesamt 25,0%). Es fanden sich bei keinem der untersuchten Parameter signifikante Unterschiede zwischen den einzelnen Gruppen.

Schlussfolgerung

Die tiefe Sklerektomie mit Implantation eines skleralen Platzhalters führt zu einer anhaltenden Senkung des Augeninnendrucks. Dabei sind T-Flux- und SK-Gel-Implantate gleich wirkungsvoll. Die Kombination mit einer Kataraktoperation hat keinen Einfluss auf das OP-Ergebnis.

Abstract

Background

The intraocular pressure (IOP) lowering effects of deep sclerectomy (partially combined with phacoemulsification) with different scleral implants (T-Flux- or SK-Gel) were investigated.

Patients and methods

In a retrospective study, 72 patients with medically uncontrollable glaucoma underwent non-penetrating deep sclerectomy. Of these, 54 patients received T-Flux implants and 18 SK-Gel implants. Examinations were carried out shortly before and after surgery, as well as after 12 months.

Results

Prior to surgery IOP was 18.4±5.5 mmHg (n=72) and 12 months after surgery it was 13.1±3.8 mmHg (n=65). The number of antiglaucomatous eyedrops used prior to surgery was 2.3±1.3 (n=72) and 12 months after surgery 0.2±0.6 mmHg (n=65). Secondary IOP-lowering surgery after 12 months was carried out on 15.3% of the operated eyes, and consecutive goniopunctures after 12 months were 25%. No significant differences were found between the two groups.

Conclusions

The short- and mid-term IOP lowering effects in deep sclerectomy with scleral implants were quite satisfying no matter which implant was used. There was no difference in deep sclerectomy whether or not combined with cataract surgery.

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Authors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    A. Wiermann, O. Zeitz, E. Jochim, E.T. Matthiessen, L. Wagenfeld, P. Galambos, N. Matthiesen & M. Klemm

  2. Augenzentrum Recklinghausen GmbH, Regensburg, Deutschland

    G. Scharioth

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  1. A. Wiermann
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  2. O. Zeitz
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  3. E. Jochim
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  4. E.T. Matthiessen
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  5. L. Wagenfeld
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  8. N. Matthiesen
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  9. M. Klemm
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Correspondence to A. Wiermann.

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Wiermann, A., Zeitz, O., Jochim, E. et al. Vergleich von resorbierbaren und nichtresorbierbaren skleralen Implantaten bei tiefer Sklerektomie (SK-Gel und T-Flux). Ophthalmologe 104, 409–414 (2007). https://doi.org/10.1007/s00347-007-1520-2

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  • DOI: https://doi.org/10.1007/s00347-007-1520-2

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