Expanded Polytetrafluoroethylene Spacer for Nonpenetrating Deep Sclerectomy Combined with Cataract Surgery

Purpose: To compare the outcomes of nonpenetrating deep sclerectomy (NPDS) with and without an expanded polytetrafluoroethylene (e-PTFE) implant combined with phacoemulsification (PE). Design: Interventional case series with concurrent control group. Materials and methods: Patients with medically uncontrolled glaucoma underwent PE nonpenetrating deep sclerectomy (NPDS) and were consecutively divided into a study group receiving an e-PTFE implant and a control group undergoing PE-NPDS. Intraocular pressure (IOP), corrected distance visual acuity (CDVA), and the number of glaucoma medications at 1 day, 1 week, 1 month, 3 months, and 6 months were recorded. Results: A total of 22 eyes of 16 patients underwent PE-NPDS, including 11 eyes receiving an e-PTFE implant and another 11 eyes with no implant. NPDS with spacer achieved successful results in all patients, including eight (72.7%) complete and three (27.3%) qualified success, 6 months, postoperatively. The corresponding values in the control group were 10 (90.9%) and 1 (9.1%), respectively. In the spacer group, mean IOP was decreased from 19.3 ± 2.8 at baseline to 12.1 ± 2.0 mm Hg at month 6 (p < 0.001). Corresponding values for the control group were 18.6 ± 3.4 and 10.6 ± 1.5 mm Hg, respectively (p < 0.001). Mean IOPs were comparable between the study groups at all time points. Implant exposure occurred in one of the patients in the study group. While the implant was extruded, the IOP was medically controlled. Conclusion: Outcomes of PE-NPDS using an e-PTFE implant were comparable to the same surgery without a spacer in the short term. Larger studies with longer follow-ups are needed to determine the efficacy and safety of this new implant.