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Abstract #26713 Published in IGR 12-3
Glaucoma drainage device implantation in pediatric patients using fibrin-glue
Freeman PD; Kahook MY; Curtis THJournal of AAPOS 2009; 13: 15
Introduction: The purpose of this study was to analyze the use of fibrin glue as an alternative to standard suturing techniques during certain stages of glaucoma drainage device (GGD) implantation in the pediatric population. Methods: Retrospective nonrandomized case-control study examining 8 consecutive cases of GDD implantation using Tisseel fibrin glue (Baxter AG, Austria) for certain portions of the procedure compared with 8 cases using standard suturing techniques. Tisseel was used to anchor the tube and the pericardial graft to the sclera. Patients were followed at 1 day, 1 week, 1 month and 3 months postoperatively. Tube position, postoperative complications, topical medicines used for glaucoma, and intraocular pressures (IOP) were recorded for each patient. Statistical analysis was carried out using t-tests and analysis of variance. Results: Mean ages of patients were 5.09(plus or minus)4.7 in the Tisseel group and 1.67(plus or minus)2.15 in the suture group. There were no significant differences detected between the 2 groups with regard to postoperative tube position, IOP, or number of glaucoma medications used. Postoperative IOP at 3 months was 14.1(plus or minus)5.38 in the Tisseel group versus 15.5(plus or minus)6.78 in the suture group. There were no cases of erosion of graft over the plate or tube in both groups. Conclusions: In the pediatric population undergoing GDD surgery, Tisseel fibrin glue is a reliable and safe method for securing GDD tubes and pericardial grafts to sclera. There does not seem to be any increase in adverse outcomes over standard suturing techniques with the use of Tisseel. Advantages include decreased OR time and decreased postoperative irritation.
P.D. Freeman.
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
