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DEEP SCLERECTOMY WITH A NONREABSORBABLE HEMA IMPLANT

DEEP SCLERECTOMY WITH A NONREABSORBABLE HEMA IMPLANT. 5th IGS April 2005 Cape Town. Dr. .J Loscos Dra. M.A Parera Prof. J de la Cámara. H.Universitari Germans Trias i Pujol Barcelona Spain. Non ionic polymer (2-hydroxietilmetacrilate) Low tendency to protein adherence

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DEEP SCLERECTOMY WITH A NONREABSORBABLE HEMA IMPLANT

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  1. DEEP SCLERECTOMY WITH ANONREABSORBABLE HEMA IMPLANT 5th IGS April 2005 Cape Town Dr. .J Loscos Dra. M.A Parera Prof. J de la Cámara H.Universitari Germans Trias i Pujol Barcelona Spain

  2. Non ionic polymer (2-hydroxietilmetacrilate) • Low tendency to protein adherence • 25% of water • Not reabsorbable

  3. Patients and Methods • 70 eyes ( 62 patients) • 35 males / 35 females • Mean Age: 68.5 years • Uncontrolled glaucoma under maximal tolerable medical treatment

  4. Patients and Methods:Diagnosis

  5. Patients and Methods: • Preop IOP <16 mmhg…………. 0 eyes 16-21 mmhg……….. 13 eyes >21 mmhg………….. 57 eyes • Preop Medication • 1 …………………….. 10 eyes • 2……………………… 29 eyes • 3……………………… 28 eyes • 3 + diamox ……… 3 eyes

  6. Surgical technique • Fornix- based conjuntival flap • Superficial escleral flap 5 x 5 mm • Mitomycin-C : 0,01% ; t = 3’ • Suture HEMA implant in scleral bed with • 10/0 nylon sutures • Suture scleral flap with 1 sutures • Closure conjunctiva

  7. UBM

  8. Early complications • Hyphema : 5 • Seidel : 3 • Coroidal detachment:3 • Anterior chamber shallowing:1 • Hipotony:6

  9. Late complications • Subconjunctival fibrosis : 2 • Isquemic bleb: 2

  10. Goniopuncture • 9 patients ( 18 %) • - 1 month : 1 • - 6 month: 8 • Mean time : 5.4 month • -Mean IOP decrease : 4.13 mmHg

  11. Postoperative follow-up

  12. Postoperative follow-up

  13. Postoperative follow-up:12 months • 50 eyes: • IOP preop: 26.2mmhg IOP postop: 17mmhg • Nº preop med:134 Nº postop med: 18 • Mean preop med: 2.6 Mean postop med:0.36

  14. Conclusion - QUALIFIED SUCCES RATE ( IOP< 21 mmHg with / without medication ) - 88% - COMPLET SUCCESS RATE (IOP < 21 mmHg without medication) - 68%

  15. Conclusion • HEMA implant is safety and effective in • control IOP • - Few postoperative complications • Further studies to compare efficiency • with other implants

  16. Thank you

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