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Abstract #90260 Published in IGR 21-3

Baerveldt glaucoma drainage implant surgery for secondary glaucoma in patients with transthyretin-related familial amyloid polyneuropathy

Kakihara S; Hirano T; Imai A; Miyahara T; Murata T
Japanese Journal of Ophthalmology 2020; 64: 533-538

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PURPOSE: To investigate outcomes associated with Baerveldt glaucoma drainage implant (BGI) surgery for refractory glaucoma secondary to transthyretin (TTR)-related familial amyloid polyneuropathy (FAP) with TTR Val30Met mutation. STUDY DESIGN: Retrospective case series. METHODS: Medical records of 5 eyes of 4 patients were reviewed. All patients had refractory glaucoma secondary to FAP with a history of unsuccessful intraocular pressure (IOP) control by trabeculectomy with mitomycin C, underwent BGI surgery, and were followed up for at least 1 year. The primary outcome was mean postoperative IOP, and secondary outcomes included the number of ocular hypotensive medications and postoperative complications. RESULTS: The mean postoperative follow-up period was 52.4 months. The mean preoperative IOP of 37.0 mmHg was reduced to 13.4 mmHg immediately postoperatively, and respective subsequent means were 15.8, 13.0, 14.4, and 16.8 mmHg at 1, 3, 6, 12, and 24 months (P < 0.05). The preoperative mean number of ocular hypotensive medications of 5.4 was reduced to respective means of 2.2, 1.6, 2.8, 2.8, and 2.8 at 1, 3, 6, 12, and 24 months. One eye suffered from IOP elevation and underwent cyclophotocoagulation at 26 months. Another was dropped from further analyses because of deterioration in the patient's general condition due to FAP progression. The remaining 3 eyes exhibited adequate IOP control (13, 13, 13 mmHg) at the final visit. CONCLUSION: BGI surgery may be the current optimal treatment for patients with refractory glaucoma secondary to TTR-FAP with regard to achieving long-term IOP reduction.

Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.

Full article

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Classification:

12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)

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