Langzeitverlauf nach tiefer Sklerektomie

 

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Zusammenfassung

Hintergrund: Ziel dieser Studie war es, die Langzeitergebnisse von bis zu 8 Jahren nach tiefer Sklerektomie (TS) zu untersuchen.

Material und Methoden: Alle Akten der Patienten, die zwischen Februar 2004 und Oktober 2005 eine TS erhielten, wurden durchgesehen und dahingehend überprüft, ob sich der Patient zwischen August 2009 und Oktober 2011 erneut vorgestellt hatte.

Ergebnisse: 74 Augen mit einer durchschnittlichen Nachbeobachtungszeit von 76,28 ± 10,6 Monaten konnten ausgewertet werden. Der intraokulare Druck (IOD) betrug präoperativ 18,37 ± 6,36 mmHg und am Ende der Nachbeobachtungszeit 12,85 ± 3,5 mmHg. Die Anzahl der drucksenkenden Augentropfen konnte von 2,36 ± 1,24 auf 1,66 ± 1,21 statistisch signifikant gesenkt werden. Die Gesichtsfelduntersuchung zeigte präoperativ eine Mean Deviation von − 9,16 ± 8,48 und zuletzt − 9,43 ± 8,07. Ein Complete Success wurde bei 5 % der Augen und ein Qualified Success bei 81 % der Augen erreicht (Referenz IOD <= 15 mmHg). 39 Augen (53 %) erhielten in dem Beobachtungszeitraum eine Zyklophotokoagulation; 15 Augen (20 %) eine Revisionsoperation.

Schlussfolgerung: Durch die TS können eine langfristige Drucksenkung sowie eine Stabilisierung des Gesichtsfelds erreicht werden.

Abstract

Background: The aim of this study was to evaluate the long-term outcome of deep sclerectomy (DS) with a follow-up of up to 8 years.

Patients and Methods: All patients who underwent a deep sclerectomy between February 2004 and October 2005 and who attended a follow-up visit between August 2009 and October 2011 were included in this study.

Results: This study evaluated 74 eyes of 65 patients with a mean postoperative follow-up of 76.28 ± 10.6 (53.65–92.02) months. Preoperative IOP was 18.37 ± 6.36 mmHg, postoperative IOP at the last follow-up was 12.85 ± 3.5 mmHg, corresponding a 30 % reduction. The number of IOP-lowering eye drops was reduced from 2.36 ± 1.24 to 1.66 ± 1.21 after more than 6 years (p < 0.05). The visual fields showed a mean deviation of − 9.16 ± 8.48 dB initially and − 9.43 ± 8.07 dB at the last follow-up (p > 0.05). Complete success (IOP ≤ 15 mmHg without eye drops or additional surgery) was achieved in 5 % of patients. Qualified success (IOP ≤ 15 mmHg with eye drops or additional surgery) was achieved in 81 %. 53 % (n = 39) underwent cyclophotocoagulation and 20 % (n = 15) needed revision surgery during the follow-up period.

Conclusion: DS is an effective long-term IOP-lowering procedure leading to visual field stabilisation.

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