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Abstract #27926 Published in IGR 13-1
Combined 25-gauge vitrectomy and posterior tube shunt placement for advanced glaucoma
Reichstein D; Kammer J; Recchia FOphthalmology 2011; 118: 77-81
Purpose: To report the initial clinical outcomes of a combined procedure utilizing 25-gauge vitrectomy and posterior tube shunt placement in eyes with refractory glaucoma not amenable to standard treatment. Design: Retrospective chart review. Participants: We included 10 eyes (10 consecutive adult patients, mean age 61 years) with advanced glaucoma and anterior segment abnormalities precluding tube placement in the anterior chamber who were treated with combined 25-gauge vitrectomy and posterior tube shunt placement. Methods: Records of consecutive patients were reviewed for demographics, etiology of glaucoma, preoperative clinical data (visual acuity, intraocular pressure, number of ocular antihypertensive medications), and postoperative outcome measures at predetermined time points. Main Outcome Measures: (1) Intraocular pressure (IOP) at 1, 2, 6, and 12 months postoperatively; (2) number of ocular antihypertensive medications needed at 12 months postoperatively; (3) visual acuity (VA) at 12 months postoperatively; and (4) incidence of hypotony, retinal detachment, endophthalmitis, and corneal decompensation. Results: Preoperatively, mean IOP was 31 mmHg, and patients required a mean of 2.5 ocular antihypertensive medications. Mean IOP at 1, 2, 6, and 12 months postoperatively were 17.0, 16.1, 17.8, and 16.1 mmHg, respectively, and significantly lower than preoperative IOP (P<0.005 at all time points). At 1 year postoperatively, 90% of patients had an IOP <20 mmHg, and 50% of patients required (less-than or equal to)2 ocular antihypertensive medications. At 1 year postoperatively, VA was the same or improved in 70% of patients, and no worse than 1 Snellen line in any patient. Corneal edema developed in 2 patients. No patient developed hypotony or endophthalmitis. Conclusions: Combined 25-gauge vitrectomy and posterior tube shunt placement can be successful in lowering IOP in eyes with advanced glaucoma not amenable to other therapies. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
F. Recchia. Division of Vitreoretinal Diseases and Surgery, Vanderbilt Eye Institute, 2311 Pierce Avenue, Nashville, TN 37232, United States.
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)