Non-Penetrating Deep Sclerectomy With SK-GEL(R) Implant versus Punch Trabeculectomy: Four Years of Follow Up

Purpose:To compare the intraocular pressure-lowering effect and complication rate of non-penetrating deep sclerectomy (NPDS) with SK-GEL® implant versus punch trabeculectomy (PT) in the management of primary open angle glaucoma (POAG). Methods:74 patients with POAG refractory to maximal tolerated medical therapy: group 1 included 43 eyes (33 patients) which underwent NPDS with reticulated hyaluronic acid (SK-GEL®) scleral implant; Group 2 included 50 eyes (41 patients) which underwent PT. Study follow-up evaluations conducted at 36 and 48 months post-procedure included best-corrected visual acuity, IOP, slit-lamp and dilated funduscopic examinations. Results:In terms of IOP control, at 36 months post-procedure, the proportion of eyes which achieved complete success was 25/33 (75.7%) in the NPDS group compared with 30/41 (73.1%) in the PT group (p=0.602). At 48 months post-procedure, the proportion of eyes which achieved complete success was 17/33 (51.5%) in the NPDS group compared with 29/41 (70.7%) in the PT group (p<0.05). Conclusions:The IOP-lowering effects of the two procedures were comparable at 36 months, while at 48 months punch trabeculectomy was associated with a significantly higher rate of complete success compared with deep sclerectomy.