Sangtam, TiakumzukRoy, SylvainMermoud, Andre2020-04-032020-04-032020-04-032020-01-0110.2147/OPTH.S244945https://infoscience.epfl.ch/handle/20.500.14299/167924WOS:000520504800001Purpose: To report the outcome and complications of a combined surgical technique of modified deep sclerectomy and trabeculectomy (mDST) for glaucoma. Patients and Methods: Retrospective study of 44 eyes of 43 patients with open and closed angle glaucoma who underwent mDST. Outcome measures were: Surgical Success with 3 criteria - (i) criterion 1 = intraocular pressure (IOP) <= 21 mmHg or reduced by >= 20% of preoperative IOP or IOP >= 6 mmHg on 2 consecutive time points after 3 months; (ii) criterion 2 = IOP <= 18 mmHg or reduced by >= 30% of pre-operative IOP or IOP >= 6 mmHg on 2 consecutive time points after 3 months and (iii) criterion 3 = IOP <= 15 mmHg or reduced by >= 40% of preoperative IOP or IOP >= 6 mmHg on 2 consecutive time points after 3 months; IOP Reduction; Use of Anti-glaucoma Medication; Complications; Visual Acuity and Postoperative Interventions. Results: Median follow-up was 40 months (range 24-77 months). At the final follow-up visit, the mean postoperative IOP was 11.5 +/- 4.7 mmHg (p<0.0001). Mean number of antiglaucoma medications decreased from 2.45 +/- 1.21 to 0.54 +/- 0.95 (p<0.0001). Surgical success in terms of IOP reduction was 50%; 43.2%; 36.4% for the 3 criteria respectively (complete success) and 70.5%; 56.8%; 47.7% for the 3 criteria respectively (qualified success). The complications noted were shallow/flat anterior chamber in 2 (4.54%), hyphema & bleb leak in 3 (6.81%), aqueous misdirection in 1 (2.27%), hypotonic maculopathy in 2 (4.45%) and hypotony requiring intervention in 6 (13.63%) eyes. Conclusion: Combined mDST was found to be an effective surgical procedure in reducing IOP. It was associated with complications commonly encountered in glaucoma filtering surgery. The use of intra-scleral space maintainer may help lower the risk of flat or shallow anterior chamber during the early postoperative period.Ophthalmologyoutcome and complicationscombined modified deep sclerectomy and trabeculectomypunch trabeculectomycollagen implanttext::journal::journal article::research article