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Abstract #6240 Published in IGR 2-2
Management of glaucoma implants occluded by vitreous incarceration
Desatnik HR; Foster RE; Rockwood EJ; Baerveldt G; Meyers SM; Lewis HJournal of Glaucoma 2000; 9: 311-316
PURPOSE: To review the authors' experience in the management of aphakic or pseudophakic patients without an intact posterior capsule, who had undergone glaucoma implant surgery complicated by vitreous incarceration in the tube, resulting in increased intraocular pressure (IOP) or combined rhegmatogenous and tractional retinal detachment. METHODS: Retrospective review of the clinical features, treatment, and outcomes of eight patients who had vitreous incarceration in a glaucoma implant drainage tube. In each patient, a model 426 (seven patients) or model 350 (one patient) Baerveldt glaucoma implant was used. RESULTS: Vitreous incarceration in the tube was first diagnosed one day to 49 weeks after surgery (mean, 7.5 weeks; median, one week). The interval between glaucoma implant surgery and pars plana vitrectomy ranged from 22-365 days (mean, 125 days). Before management with pars plana vitrectomy or Nd:YAG laser vitreolysis, IOP ranged from 25-62 mmHg (mean, 40 mmHg). Four patients were initially treated with Nd:YAG laser vitreolysis, which was successful in only one patient. Six patients were successfully treated with pars plana vitrectomy, and one patient declined surgery. Follow-up after treatment of the incarceration ranged from five weeks to 15 months (mean, 8.3 months). After pars plana vitrectomy, IOP ranged from 9-24 mmHg (average, 14 mmHg). Postoperative visual acuity remained within one line of the preoperative visual acuity in each of the six patients undergoing pars plana vitrectomy. CONCLUSIONS: Pars plana vitrectomy is effective in managing vitreous incarceration in glaucoma implant tubes. Previous anterior vitrectomy does not prevent incarceration.
Dr. R.E. Foster, Cincinnati Eye Institute, 10494 Montgomery Road, Cincinnati, OH 45242, USA
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
