Longterm follow-up after deep sclerectomy in patients with pseudoexfoliative glaucoma

Purpose: To compare the longterm results in pseudoexfoliative glaucoma and primary open-angle glaucoma (POAG) following deep sclerectomy with implant. Methods: A total of 28 pseudoexfoliative glaucoma eyes and 27 POAG eyes were consecutively included in the study. Intraocular pressure (IOP) and number of glaucoma medications were compared before surgery and at every postoperative visit. Most patients included had very advanced glaucoma and were using multiple therapies (mean 3.3 and 3.6 in the pseudoexfoliative glaucoma and POAG groups, respectively) and the duration of the disease was more than 8 years in both groups. The definition of complete success was the achievement of IOP < 19 mmHg without therapy. Results: After a mean follow-up time of 45 months in the pseudoexfoliative glaucoma group and 43 months in the POAG group, 50.0% of the pseudoexfoliative glaucoma group were considered to represent complete success compared with 33.3% of the POAG group (NS). In survival analyses controlling for covariates, it was found that patients with pseudoexfoliative glaucoma had a higher rate of success over time than POAG patients (p = 0.014). Furthermore, the duration of glaucoma prior to surgery had a negative influence on the success rate (p = 0.034). Four years after surgery, the mean IOP was 15.5 +/- 5.3 mmHg in the pseudoexfoliative glaucoma group and 13.6 +/- 3.5 mmHg in the POAG group (NS). The mean number of medications used by each group at that time was 1.7 +/- 1.5 and 1.2 +/- 1.1, respectively (NS). Conclusion: The present study suggests that deep sclerectomy is a safe procedure in pseudoexfoliative glaucoma. Half of the patients were regulated without therapy after 45 months.