Abstract
ABSTRACTPurpose: To describe a new ultrasound biomicroscopic (UBM) sign seen in patients who underwent deep sclerectomy (DS) as a surgical procedure for the management of uncontrolled primary open-angle glaucoma (POAG). The presence of this sign in ultrasound biomicroscopy is suggested to be an indicator of successful surgery. We would like to name this sign as the “dolphin head sign.”Design: Prospective interventional study.Materials and methods: Twenty-eight eyes of 17 patients with POAG underwent DS with intraoperative mitomycin C (MMC) 0.3% applied for 2 minutes under the superficial scleral flap. Patients were followed up for a minimum of 6 months. Ultrasound biomicroscopy was done at the third postoperative month to evaluate the surgical area in both successful and failed cases.Results: The study included 28 eyes of 17 patients. The mean age of the study group was 42.90 ± 14.37 years (20–64 years). The study included 10 females and 7 males. The mean preoperative intraocular pressure (IOP) was 24.57 ± 6.37 mm Hg (20-38 mm Hg). The mean best corrected visual acuity (BCVA) was 0.57 ± 0.3 (0.05–1.00). Complete success has been achieved in 21 eyes (75%) during the follow-up period, with a mean IOP of 12.00 ± 3.86 mm Hg (6–20 mm Hg). The dolphin head sign was demonstrated only in successful cases, whereas the unsuccessful cases failed to show the typical sign.Conclusion: The presence of a “dolphin head” configuration in UBM images could be taken as an indicator of successful DS.How to cite this article: Abdelrahman AM, El Cheweikh HM, El-Fayoumi DMS, Allam RSHM. A New Ultrasound Biomicroscopic Sign seen after Deep Sclerectomy (Dolphin Head Sign). J Curr Glaucoma Pract 2016;10(2):56-59.
Highlights
In the 1990s, nonpenetrating glaucoma surgery (NPGS) like viscocanalostomy and deep sclerectomy (DS) were introduced as safer alternatives to trabeculectomy.1,21,2Professor, 3,4Lecturer 1-4Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, EgyptThis is a prospective interventional study including 28 eyes of 17 patients having primary open-angle glaucoma (POAG) for which DS was done
Complete success has been achieved in 21 eyes (75%) during the follow-up period, with a mean intraocular pressure (IOP) of 12.00 ± 3.86 mm Hg (6–20 mm Hg)
The presence of a “dolphin head” configuration in ultrasound biomicroscopic (UBM) images could be taken as an indicator of successful DS
Summary
1,2Professor, 3,4Lecturer 1-4Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, Egypt. This is a prospective interventional study including 28 eyes of 17 patients having primary open-angle glaucoma (POAG) for which DS was done. The patients were followed up for a minimum period of 6 months. Deep sclerectomy was performed under the standard peribulbar anesthesia. Fornix-based conjunctival incision was done followed by a 4 × 3 mm rectangular superficial scleral flap using a crescent blade. Mitomycin C soaked sponges (0.3% for 2 minutes) were applied under the superficial scleral flap and the conjunctiva. Deep flap dissection was carried out with deroofing of Schlemm’s canal. Percolation was tested using sponges and the deep flap was excised. The whole operations were performed by a single experienced surgeon (AA)
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