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.