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Abstract #9049 Published in IGR 5-2
Suprachoroidal Seton implantation in refractory glaucoma: a novel surgical technique
Ozdamar A; Aras C; Karacorlu MJournal of Glaucoma 2003; 12: 354-359
PURPOSE: To describe a new surgical technique in which aqueous humor is diverted from the anterior chamber to the suprachoroidal space for the augmentation of uveoscleral outflow in the management of refractory glaucoma. METHODS: Four painful-blind eyes of four consecutive patients were included in the study. Mean age of patients was 54.7± 9.2 years. Preoperative diagnosis was neovascular glaucoma complicating diabetic retinopathy in three cases and chronic angle-closure glaucoma in one case. Mean preoperative intraocular pressure (IOP) of the patients receiving two medications was 58.5 ± 9.2 mmHg. A modified Krupin eye valve with disc was implanted into the suprachoroidal space. The anterior tube part of the Seton device was placed into the anterior chamber through the long scleral tunnel for draining the aqueous humor from the anterior chamber to the suprachoroidal space. RESULTS: The placement of modified Krupin eye valve with disc to the suprachoroidal space was achieved in all cases. While mean preoperative IOP was 58.5 ± 9.2 mmHg, it was 14.2 ± 4.7mmHg at one week postoperatively. It was 13.5 ± 4.6 and 15 ± 4.9 mmHg at one and three months, respectively. At the last follow-up visit, mean IOP was 17.25 ± 5.37 mmHg, ranging from 12-24 mmHg. Choroidal detachment was developed in one case and regressed in six weeks. Rubeosis irides regressed at the third month in three cases. None of the eyes developed suprachoroidal hemorrhage, retinal detachment, or phthisis bulbi. CONCLUSION: The drainage of aqueous humor from the anterior chamber to the suprachoroidal space with the implantation of the glaucoma Seton device is effective in lowering IOP in refractory glaucoma.
Dr. A. Ozdamar, Valikonagi Caddesi Leylak Sokak, No:3 D 2A, Basinkoy/Istanbul, Turkey. aozdamar@iris.com.tr
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
