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Abstract #6911 Published in IGR 4-1
Effectiveness of nonocclusive ligature and fenestration used in Baerveldt aqueous shunts for early postoperative intraocular pressure control
Kansal S; Moster MR; Kim D; Schmidt CM; Wilson RP; Katz LJJournal of Glaucoma 2002; 11: 65-70
PURPOSE: The authors determined the effectiveness of two different methods of modification of Baerveldt aqueous shunts in the control of early postoperative intraocular pressure. METHODS: The authors retrospectively reviewed charts of 122 eyes of 113 patients who underwent a Baerveldt 350-mm2 modified with tube fenestration and charts of 129 eyes of 122 patients who underwent a Baerveldt 350-mm2 modified with a nonocclusive ligature to examine early postoperative intraocular pressure control. In the fenestration group, the tube was modified with a 4-0 intraluminal suture and an occlusive 6-0 external polyglactin ligature before ocular placement. After ocular placement, the tube was further modified with one to three perforating fenestrations. In the nonocclusive-ligature group, the tube was modified with a 4-0 nylon intraluminal suture with a nonocclusive 6-0 external polyglactin ligature before ocular placement. RESULTS: A total of 94 eyes (77%) achieved adequate intraocular pressure control with or without adjunctive medications and. A total of 28 eyes (23%) had postoperative hypertension or hypotony in the fenestration group versus 81 (62.8%) and 48 (37.2%) eyes in the nonocclusive-ligature group (p = 0.014), respectively. The mean change in intraocular pressure (IOP) preoperatively and three months postoperatively was 18.2 versus 21.0 mmHg (p = 0.11) in the fenestration and nonocclusive-ligature groups, respectively. CONCLUSIONS: Both the nonocclusive ligature and the fenestration methods provide desirable decreases in IOP in the immediate postoperative period and three months postoperatively; however, the fenestration modification may achieve adequate IOP control more often in the early postoperative period.
Dr. S. Kansal, Wills Eye Hospital, Glaucoma Section, Philadelphia, PA 19107, USA
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
