Ophthalmology Research
Open AccessEfficacy and Safety of Deep Penetrating Sclerectomy in Advanced Primary Open-Angle Glaucoma: A Prospective Single-Center Study of 91 Cases with 12-Month Follow-Up
Authors: Hamahoullah SE, Souleimane AD, H'Biba MTM, Ahmed MM.
Abstract
Context Primary open-angle glaucoma (POAG) is a major cause of blindness in sub-Saharan Africa, where late diagnosis and follow-up constraints complicate management. In Mauritania, its increasing prevalence requires a rethinking of available surgical options.
Objective: To evaluate the 12-month results of deep penetrating sclerectomy (DPS) in patients with advanced POAG, by analyzing both its eye pressure efficacy, its impact on drug treatment, and its possible complications.
Methodology: Prospective, single-center interventional study including 91 patients with advanced POAG, who underwent surgery using a standardized DPS technique. Intraocular pressure (IOP), topical treatment, complications, and surgical success rate were assessed at regular intervals up to 12 months postoperatively.
Results: A significant reduction in IOP was observed (−29.8% at M12), associated with a notable decrease in the number of treatments. The absolute success rate (without eye drops) was 76%, with a favorable safety profile. Some minor complications were observed, mainly transient hypotony and a few cases of cataract. A lower eye pressure response was noted in patients of Black African origin, raising questions about underlying anatomical or genetic factors.
Conclusion: In this resource-limited African context, DPS appears to be a realistic and relatively safe surgical alternative. While the 12-month results are encouraging, longer-term monitoring and a comparative study with other techniques remain essential to better define its place in the therapeutic arsenal.
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