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J Glaucoma ; 26(12): 1081-1085, 2017 Dec.
Article in English | MEDLINE | ID: mdl-29045328

ABSTRACT

PURPOSE: The purpose of this is to describe a venting stitch modification for valveless glaucoma aqueous shunts and characterize early postoperative intraocular pressure (IOP) and glaucoma medication use following the modification. MATERIALS AND METHODS: Retrospective chart review of 61 sequential patients undergoing Baerveldt glaucoma implant (BGI)-350 implantation at the Doheny Eye Institute. Twenty-four patients received a glaucoma shunt with venting stitch modification (modified BGI) and 37 patients received an unmodified shunt (BGI-only). IOP, number of glaucoma medications, and number of hypotony cases (intraocular pressure ≤5 mm Hg) were compared between the groups. T-tests were used for statistical analysis. RESULTS: At postoperative-day 1, mean IOP was significantly lower compared with preoperatively in the modified BGI group (14 mm Hg; reduced by 51%; P<0.0001) but not the BGI-only group (27 mm Hg; P=0.06). IOP difference between groups persisted till immediately before tube opening (P=0.005) and fewer IOP-lowering medications needed in the modified BGI group (P<0.0001). One case (4.2%) of postoperative hypotony was encountered with BGI modification, which resolved after the stitch was removed in clinic. CONCLUSIONS: The venting stitch valveless shunt modification allows for effective, reliable, and safe control of early postoperative IOP.


Subject(s)
Glaucoma Drainage Implants , Glaucoma/surgery , Intraocular Pressure/physiology , Female , Glaucoma/physiopathology , Humans , Male , Middle Aged , Postoperative Period , Prosthesis Design , Retrospective Studies , Tonometry, Ocular , Treatment Outcome , Visual Acuity
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