Nonpenetrating deep sclerectomy versus trabeculectomy in bilateral primary open angle glaucoma

Objective: To establish the efficacy and safety of nonpenetrating deep sclerectomy versus trabeculectomy in primary open-angle glaucoma. Design: Prospective randomized trial. Participants: Thirty-nine patients (78 eyes) with bilateral primary open angle glaucoma were included in the study. Intervention: Eyes were randomly assigned to receive deep sclerectomy in one eye and trabeculectomy in the other eye. Main Outcome Measures: Mean intraocular pressure (IOP), postoperative medications, visual acuity, success rate, and complications. Results: At 12 months, mean IOP reduction was 12.3 +/- 4.2 (sclerectomy) versus 14.1 +/- 6.4 mmHg (trabeculectomy) (P = 0.15), and an IOP less than or equal to 21 mmHg was achieved in 36 (92.3%) and 37 eyes (94.9%) (P = 0.9), respectively. Complications included three (7.7%) flat/shallow anterior chambers and one (2.6%) hypotony (trabeculectomy), whereas internal iris incarceration was encountered in two eyes (5.1%) (sclerectomy). Conclusions: Deep sclerectomy may provide comparable IOP reduction with fewer complications in management of primary open angle glaucoma. Ophthalmology 2000;107:1671-1674 (C) 2000 by the American Academy of Ophthalmology.