A Novel Sclerectomy Technique for Glaucoma and Ocular Hypertension Treatment
Ahmed S. Elbably *
Riyadh National Hospital, Riyadh, Saudi Arabia.
Ehab Ahmed
Riyadh National Hospital, Riyadh, Saudi Arabia.
Mohamed M. Abo-Zaed
Egyptian Eye Academy, Cairo, Egypt
Mohammed S. Elbably
Magrabi Eye Hospital, Cairo, Egypt.
Tag El-Din M. Othman
Aswan University Hospital, Faculty of Medicine, Aswan University, Aswan, Egypt.
Ahmed Mousa
Department of Ophthalmology, College of Medicine, King Saud University, Saudi Arabia and Glaucoma Research Chair, Department of Ophthalmology, College of Medicine, King Saud University, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Purpose: To introduce and evaluate the efficacy and safety of a new surgical scleral technique for treatment of glaucoma based on the concept of scleral biomechanics.
Methods: Twelve 3-month-old New Zealand white rabbit eyes were operated under general anesthesia. Single large rectangular full thickness sclerectomy (3 mm limbal x 5 mm) exposing the choroid was performed in each eye. The intraocular pressure (IOP) was measured preoperatively, one day, one week and one month postoperatively.
Results: Twelve eyes of 6 New Zealand white rabbits were operated with sector sclerectomy technique. The mean (±SD) intraocular pressure (IOP) was significantly reduced from a preoperative value of 6.0 (±0.0) mmHg to 2.0 (±0.0) mmHg (p = 0.003) in the post-operative assessment. The IOP was quite stable in the following one week and one month follow up assessments at 2.0 (±0.0) mmHg (p = 0.998). Eight out of 12 (66.7%) operated eyes had no postoperative complications. Four (33.3%) eyes faced different complications where: one (8.3%) had corneal perforation by traction suture, 3 (25%) had vitreous loss (one mild and two severe), while one of them (8.3%) had bleeding.
Conclusion: Full thickness sector sclerectomy can change the scleral biomechanical behavior leading to highly significant intraocular pressure reduction.
Keywords: Glaucoma, sector sclerectomy, new glaucoma technique.