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Abstract #26650 Published in IGR 12-3
Glaucoma tube shunt implantation through the ciliary sulcus in pseudophakic eyes with high risk of corneal decompensation
Weiner A; Cohn AD; Balasubramaniam M; Weiner AJJournal of Glaucoma 2010; 19: 405-411
See also comment(s) by Jeffrey Freedman • Francisco Fantes •
Purpose: To summarize our clinical experience with implanting Baerveldt glaucoma tube shunts through the ciliary sulcus in eyes with a posterior chamber intraocular lens and shallow anterior chambers, corneal transplants, guttata or edema. Patients And Methods: A retrospective interventional nonrandomized noncomparative case series. Main outcome measure was postoperative corneal status. Secondary outcome measures included postoperative intraocular pressure (IOP), visual acuity and complications. Results: Thirty-six eyes of 32 patients were identified through chart review. Follow-up period was 21.8(plus or minus)16.6 months (mean(plus or minus)standard deviation, range: 4.0 to 58.5?mo). At final visit, all 23 preoperative clear native corneas and 6 of 7 corneal transplants remained clear. Thus, of the 30 preoperative clear corneas, only 1 decompensated. Preoperative IOP was 27.9(plus or minus)11.8?mm Hg (range: 12 to 59mm Hg), reduced postoperatively to 10.1(plus or minus)3.9?mm Hg (range: 2 to 21mm Hg, P=0.0001), a reduction of 58.2%(plus or minus)19.3% (range: 5.0% to 95.4%). Final IOP was 5 and (less-than or equal to)21?mm Hg in 33 of 36 eyes (91.7%). It was lowered by 30% or more in 34 of 36 eyes (94.4%). Conclusions: Although previously published studies demonstrated a significant risk of corneal decompensation after angle or pars plana tube implantation, our clinical experience suggests that ciliary sulcus tube implantation in eyes with a posterior chamber intraocular lens is a safe and effective procedure even in eyes with high risk of corneal decompensation.
A. Weiner. Associated Vision Consultants, 29275 Northwestern Highway, Southfield, MI 48034, United States. aweiner@comcast.net
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
