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Facoesclerectomía profunda no perforante: Resultados y complicaciones

2003; Elsevier BV; Volume: 78; Issue: 9 Linguagem: Espanhol

10.4321/s0365-66912003000900008

1989-7286

FJ Muñoz-Negrete, Gema Rebolleda, Susana Noval,

Retinal Diseases and Treatments

espanolObjetivo: Evaluar la eficacia y seguridad de la facoesclerectomia profunda no perforante (FEPNP) con implante de acido hialuronico reticulado en cirugia combinada de catarata y glaucoma. Metodos: Analisis retrospectivo no comparativo de 39 ojos (36 pacientes) en los que se realizo FEPNP. Los datos recogidos antes de la cirugia y 1, 7 dias, 1, 3, 6 y 12 meses tras FEPNP fueron agudeza visual (AV), presion intraocular (PIO), numero de farmacos antiglaucomatosos y complicaciones intra y postoperatorias. Resultados: La PIO media preoperatoria fue 23,1 mm Hg (DE: 8,8), produciendose una reduccion estadisticamente significativa tras la FEPNP durante todo el seguimiento (P = 0,000), siendo de 8,63 (DE: 8,55) y 6,88 mm Hg (DE: 5,46) a los 6 y 12 meses respectivamente. El porcentaje medio de reduccion de PIO obtenido fue 32,78 (DE: 21,30) y 27,74 % (DE: 18,15) a los 6 y 12 meses respectivamente. El numero medio de farmacos antiglaucomatosos antes de la cirugia era 1,76 (DE: 0,85), reduciendose significativamente en todos los periodos postoperatorios (P = 0,000). Un ano tras FEPNP el numero medio de farmacos era 0,34 (DE: 0,60) y un 71,9% de los ojos no precisaban tratamiento medico. En el 84,2% de los ojos se alcanzo la PIO objetivo preestablecida segun la severidad de su glaucoma. Un ano tras FEPNP, la AV media mejoro casi 3 lineas. Reaccion inflamatoria severa (7,7%) e hifema (5,1%) fueron las complicaciones mas frecuentes. Conclusiones: Estos resultados preliminares sugieren que la FEPNP podria ser una tecnica eficaz y segura de cirugia combinada de catarata y glaucoma. EnglishPurpose: To evaluate the efficacy and safety of phaco-deep nonpenetrating sclerectomy (PDNS) with reticulated hyaluronic acid implant for glaucoma combined surgery. Material and Methods: Noncomparative retrospective study of 39 eyes of 36 patients who underwent PDNS. Preoperative and 1, 7 days, 1, 3, 6 and 12 months after surgery data retrieved were best-corrected visual acuity, intraocular pressure (IOP), number of glaucoma medications and intra and postoperative complications. Results: Mean preoperative IOP was 23.1 mm Hg (SD: 8.8). Statistically significant reduction in IOP was observed in all postoperative visits (P = 0.000); a mean IOP reduction of 8.63 mm Hg (SD: 8.55) and 6.88 mm Hg (SD: 5.46) was found 6 and 12 months after surgery respectively. Mean percentage of IOP reduction was 32.78% (SD: 21.30) and 27.74% (SD: 18.15) six and twelve months after surgery respectively. Mean preoperative number of glaucoma medications was 1.76 (SD: 0.85). In all postoperative visits a statistically significant reduction in the number of glaucoma medications was observed (P = 0.000). One year after PDNS, mean number of antiglaucoma drugs was 0.34 (SD: 0.60), and 71.9% of the eyes did not need any glaucoma medication. Predetermined target IOP was achieved in 84.2% of the eyes. A gain of almost 3 lines of mean VA was observed one year after surgery. Severe inflammatory reaction (7.7%) and hyphema (5.1%) were the most frequent observed complications. Conclusions: These preliminary results suggest that PDNS could be a safe and effective surgical technique for combining glaucoma and cataract surgery.