Post-operative inflammation following deep sclerectomy with collagen implant versus standard trabeculectomy

Abstract 

· Background: An investigation was carried out to compare post-operative inflammation following deep sclerectomy with collagen implant (DSCI) versus standard trabeculectomy. · Methods: In this prospective randomized study, 46 eyes of 46 Caucasian patients with medically uncontrolled chronic open-angle glaucoma and without previous glaucoma surgery underwent filtering surgery. Twenty-four eyes underwent DSCI. Twenty-two eyes underwent standard trabeculectomy. Pre- and post-operative flare, measured using laser flare photometry, were compared between the two groups. · Results: In both groups, the mean anterior chamber flare increased on the first post-operative day, then decreased progressively. DSCI was associated with lower flare measurements post-operatively. The difference was statistically significant up to 1 month post-operatively: 16.3±7.8 vs 72.5±38.9 (P<0.001) at 1 day, 7.8±4.6 vs 44.7±29.2 (P<0.001) at 1 week, 5.9±1.6 vs 7.0±2.8 (P=0.012) at 1 month, 6.4±1.8 vs 6.5±1.9 (P=0.77) at 2 months, 5.9±1.8 vs 6.1±1.6 (P=0.65) at 3 months. · Conclusion: Surgically induced inflammation can be reduced with DSCI. This may be due to the lack of iridectomy, irrigation, and penetration of the anterior chamber. Eyes at increased risk of post-operative inflammation, such as those with uveitic or traumatic glaucoma, may benefit from this procedure. Further studies are needed to evaluate the long-term functional and anatomical outcomes of DSCI.