Prospective pilot study comparing deep sclerectomy outcomes with a long-term and intense corticosteroid treatment versus a standard one

OBJECTIVE: To compare prospectively intraocular pressure (IOP) results after deep sclerectomy (DS) using a topical short-term corticosteroid treatment (STCT, 1 month) versus a topical long-term and intense corticosteroid treatment (LTCT, 6 months) in a two2 year-follow-up. METHODS: Patients with medically uncontrolled open angle glaucoma were prospectively recruited and underwent a DS. RESULTS: We operated 45 eyes of 45 patients, 22 in STCT group and 23 in LTCT group. Median preoperative IOP was 27 (22–36.75) mm Hg for STCT and for 25 (22–28) mm Hg for LTCT group without significant difference (p=0.195). Median postoperative IOP was 4 (3–6.25) mm Hg in STCT group versus 2 (0–5) mm Hg in LTCT at day 1 (p=0.003); 8.5 (5.75–11.25) mm Hg (STCT) vs 6 (4–9) mm Hg (LTCT) at week 1 (p=0.079); 17.5 (14.75–22.25) mm Hg (STCT) vs 13 (10–14) mm Hg (LTCT) at month 1 (p=0.001); 16 (12–20) mm Hg (STCT) vs 12 (10–15) mm Hg (LTCT) at month 3 (p=0.008); 17 (14–20) mm Hg (STCT) vs 12 (10–14) mm Hg (LTCT) at month 6 (p=0.000); 16 (14–20) mm Hg (STCT) vs 14 (10–16) mm Hg (LTCT) at year 1 (p=0.002) and 17.5 (15–19) mm Hg (STCT) vs 14 (12–16) mm Hg (LTCT) at year 2 (p=0.001). The complete success rate was 54.5 % in STCT and 87 % in LTCT (p=0.018). CONCLUSIONS: A long-term and intensive postoperative treatment enhances success rate in DS compared with a standard protocol.