Comparative evaluation of the hypotensive effectiveness of biodegradable drainage implants in non-penetrating surgery for open-angle glaucoma

PURPOSE. To compare the hypotensive effectiveness of Glauteks and HealaFlow drainage implants in non-penetrating deep sclerectomy (NPDS) in patients with primary open-angle glaucoma (POAG).

METHODS. The study included 56 patients (56 eyes), of them 19 had moderate POAG and 37 had advanced POAG. The intraocular pressure (IOP) level was 27.8±3.6 mm Hg on the hypotensive regimen. Glauteks drainage impalnt was used in the first group (27 eyes), HealaFlow drainage implant — in the second group (29 eyes).

RESULTS. On the 1st day after surgery the IOP was 13.3±1.8 mm  Hg in the 1st group, and 13.6±1.7 mm  Hg in the 2nd group. After 3 months, the average IOP level was 15.6±1.4 mm Hg in the 1st group, and 15.9±1.6 mm Hg in the 2nd group. All patients underwent a planned Descemet's goniopuncture at 3 months. After one year, the IOP level in the 1st group amounted to 17.3±1.7 mm Hg (IOP normalization achieved in 96% of eyes), with 67% of the eyes not requiring hypotensive therapy. In the 2nd group — 18.0±1.8 mm  Hg (IOP normalization achieved in 93% of eyes), with 62% of the eyes not requiring hypotensive therapy. After two years, 25 patients of the 1st group had normalized IOP and was 18.2±1.5 mm  Hg, of them 30% did not use hypotensive therapy. In the 2nd group, 27 eyes had IOP of 18.3±1.7 mm Hg, of which 28% did not require hypotensive therapy. Over the 2 years of follow-up, reoperations were required in 11% of eyes in the 1st group and in 14% of eyes in the 2nd group.

CONCLUSION. The use of biodegradable Glautex and HealaFlow drainage devices in NPDS allowed achieving persistent normalization of IOP in the vast majority of patients with POAG — 89% and 86%, respectively — within 2 years of follow-up.

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