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Tesi etd-03142019-170728


Thesis type
Tesi di dottorato di ricerca
Author
NASINI, FRANCESCO
URN
etd-03142019-170728
Title
New developments in filtering surgery for glaucoma patients
Settore scientifico disciplinare
MED/30
Corso di studi
FISIOPATOLOGIA CLINICA
Supervisors
tutor Prof. Nardi, Marco
Parole chiave
  • trabeculectomy
  • glaucoma device
  • glaucoma
  • glaucoma surgery
Data inizio appello
29/03/2019;
Consultabilità
Parziale
Data di rilascio
29/03/2089
Riassunto analitico
The aim of the study is to evaluate safety and efficacy of new surgical techniques and new devices used to lower intraocular pressure (IOP) in subjects with uncontrolled primary open-angle glaucoma. Trabeculectomy, Ex-Press with everting suture and a novel aqueous humour microshunt were investigated
METHODS: 67 eyes diagnosed with open angle glaucoma with IOPs that are not controlled on maximum tolerated glaucoma medications were randomized in 3 group. Group one’s patients underwent trabeculectomy with releasable suture. Patients in the second group received an Ex-Press with releasable suture and scleral-flap everting suture. Patients in the third group were operated with a novel aqueous humour microshunt. Subjects were examined at 1 day, 1 week, 1,3, 6, 12 and 18 months.
RESULTS: At 18 months mean IOP decrease from preoperative value in all groups. In group 1 (25 eyes) from 22.60 ±4,42 mmHg to 14.58 ±3.44 mmHg, in group 2 (25 eyes) from 23.37 ±4.98 mmHg to 14.2 ±3.51 mmHg, in group 3 (17 eyes) from 23.22 ±4,25 mmHg to 12.28 ±2.69 mmHg. Mean medications number dropped from preoperative values in all groups. In group 1 from 2.93 ±0.98 to 0.83 ±0.94, in group 2 from 3.01 ±0.81 to 0.72 ±0.74, in group 3 from 2.86 ±1.00 to 0.29 ±0.47.
DISCUSSION: The three techniques analysed showed a good safety profile, especially group 2 and group 3 showed a low complications rate (6 and 4 respectively, p<0.05).Greater IOP reduction was observed in group 3 compared to group 1 (p=0.023) but not to group 2 (p=0.68). Considering the lower number of post-operative medications and the low complications rate microshunt represents a valid and promising alternative to trabeculectomy and Ex-Press.
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