Self-engineered Acry C plants in nonpenetrating glaucoma surgery.

BACKGROUND: Analysis of safety and efficacy of self-engineered polymethylmethacrylate (Acry C) implants in nonpenetrating glaucoma surgery (NPGS) for control and maintenance of intraocular pressure (IOP) in primary open angle glaucoma (POAG) patients.

MATERIALS AND METHODS: This was a hospital-based randomized study. Fifty eyes of 50 POAG patients were divided into 3 groups based on preoperative IOP range. NPGS was done with polymethylmethacrylate implants made from haptics of intraocular lenses. All patients were followed up after 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. Preoperative IOP range was from 25.62 ± 1.72 to 41.66 ± 1.15 mmHg. Postoperative success was defined as IOP <21 mmHg at 1 month in the absence of additional antiglaucoma medication or other treatment.

RESULTS: A significant reduction in IOP was observed postsurgery in all three groups, changing from a preoperative mean of 25.62 ± 1.72 mmHg, 34.38 ± 2.27 mmHg, and 41.66 ± 1.15 mmHg to a postoperative mean of 13.27 ± 2.13 mmHg, 16.50 ± 2.74 mmHg, and 17.66 ± 1.52 mmHg, respectively ( P < 0.001) at 12 months. No significant difference was seen with change in position of the implant, i.e., convexity facing limbus or fornix. No intraoperative complications were observed. The main postoperative complication was failure of filtration in 1 case (3.44%) from Group 1, 5 cases (27.78%) from Group 2, and all 3 cases (100%) from Group 3 at 1 month postoperatively. Thus, 9 eyes (41%) required postoperative antiglaucoma medications following which the IOP was controlled.

CONCLUSION: NPGS with Acry-C implants is a safe and cost-effective (<1 US dollar) procedure for control of IOP in POAG patients especially those with moderately elevated IOPs.