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Abstract #8538 Published in IGR 5-1
Clinical experience of e-PTFE membrane implant surgery for refractory glaucoma
Kim CY; Kim Y; Choi S; Lee SH; Ahn BBritish Journal of Ophthalmology 2003; 87: 63-70
AIMS: To evaluate the clinical efficacy of membrane tube implant made of expanded polytetrafluoroethylene (e-PTFE, Gore-Tex) membrane and silicone tube in treating refractory glaucoma. METHODS: A retrospective chart review was performed on 43 eyes of 40 patients who underwent glaucoma tube shunt implant surgery using double layered e-PTFE membrane and silicone tube to treat refractory glaucoma. The surgeries were performed from May 1991 to September 1995, and the subjects were patients with terminal glaucoma without useful vision on the study eye. RESULTS: The mean follow up period was 32.9 months. The Kaplan-Meier survival for intraocular pressure (IOP) control (IOP between 6 and 21 mmHg without significant complication) was 80.9% at one year, 73.9% at two years, and 62.2% at three years after surgery. After excluding three eyes of three patients who were dropped within three months after surgery and did not have any serious complication or problem in IOP control, the average preoperative IOP was 42.5 (SD 14.6) mmHg and IOP on the last visit was 17.3 (10.2) mmHg (p = 0.000, n = 40). The number of antiglaucoma medications before surgery (2.2 (0.6)) was reduced to 0.5 (0.8) on the last visit (p = 0.000). The IOP was controlled within the range of 6-21 mmHg in 26 eyes (65.0%). In the remaining 14 eyes (35%), we could not control the IOP or additional surgery was needed to control the IOP or to treat severe complications. Two cases of endophthalmitis and three of phthisis were found as serious complications. The other complications were similar to those of other commercially available glaucoma implants. CONCLUSIONS: A comparable clinical result was obtained with this new implant as with the other commercially available implants. This implant with a thin and non-rigid reservoir has a potential to reduce some complications associated with the large volume and rigid consistency of the other implants, although it is not yet proved. This membrane tube implant may be considered as another substitute in the surgery of refractory glaucoma.
Dr. C. Kim, Department of Ophthalmology, College of Medicine, Chungnam National University, Taejon, South Korea. kcs61@cnu.ac.uk
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
