Vision
Long-Term Outcomes and Safety of Non-Cyclodialytic, Bleb-Independent Surgical Enhancement of Uveoscleral Outflow in Open-Angle Glaucoma, with Evaluation of the Role of Conjunctival Lymphatic Vessels in Suprachoroidal Drainage
Par Винод Кумар, Mikhail Aleksandrovich Frolov, Galina Nikolaevna Dushina et 3 autres.
Contenu en anglais
Résumé
Purpose
To evaluate long-term outcomes and safety of non-cyclodialytic, bleb-independent surgical enhancement of uveoscleral outflow for intraocular pressure (IOP) reduction in open-angle glaucoma (OAG), and to assess the role of conjunctival lymphatic vessels (CLVs) in suprachoroidal drainage.
Methods
In this single-center consecutive case series, 70 eyes of 63 patients (mean age 75.0 years; 70% female) with moderate-to-severe OAG underwent uveoscleral outflow enhancement. Twenty-two eyes had standalone surgery; 48 eyes had combined phacoemulsification with glaucoma surgery. Mean follow-up was 24.1 months (range 5.3–60.4). Primary outcomes were IOP reduction and surgical success by Kaplan–Meier analysis (sustained failure: IOP > 18 mmHg or < 20% reduction from baseline at two consecutive available postoperative visits, excluding day 1). CLVs were assessed by slit-lamp and OCT at 11 time points over 36 months. Mixed-effects models with random intercept per eye were used for repeated measurements. Logistic regression with cluster-robust standard errors evaluated predictors of CLV visibility.