J GlaucomaJune 20227 citations

Novel Surgical Techniques to Control Flow With PreserFlo MicroShunt for Late Hypotony After Baerveldt Drainage Device Implantation.

Fritsche Raphael, Müller Luzia, Bochmann Frank

View on PubMed DOI: 10.1097/IJG.0000000000002061

AI Summary

This study used a PreserFlo MicroShunt to modulate flow within existing Baerveldt implants, successfully treating late hypotony in two patients. This offers a novel, effective approach to manage low eye pressure.

Abstract

We report a new surgical technique for controlling flow with a PreserFlo MicroShunt, in patients with late postoperative hypotony, following a Baerveldt glaucoma drainage device implantation. We present 2 cases with late postoperative hypotony after Baerveldt-shunt implantations. In both cases, the outflow resistance of the Baerveldt tube was modulated by the insertion of a PreserFlo MicroShunt into the lumen of the Baerveldt tube. In the first case, the Microshunt was inserted through the distal opening of the tube in the anterior chamber. In the second case, an end plate, sided approach was chosen after opening the conjunctiva. In both cases, the hypotony was successfully treated. The intraocular pressure rose immediately after the procedure, and it remained well controlled within the targeted range during the first postoperative months without additional pressure-lowering medication. This novel surgical technique provided predictable flow reductions, according to the Hagen-Poiseuille equation. This approach offers a valuable alternative to permanent tube ligation.

MeSH Terms

DrainageGlaucoma Drainage ImplantsHumansIntraocular PressurePostoperative ComplicationsRetrospective Studies

Shields Classification

Ch. 25Glaucomas Associated with Ocular Trauma

Ch. 27Management of the Glaucoma Patient

Ch. 40Filtering Surgery

Key Concepts6

A novel surgical technique involving the insertion of a PreserFlo MicroShunt into the lumen of a Baerveldt tube successfully treated late postoperative hypotony after Baerveldt-shunt implantations in 2 cases.

TreatmentCase seriesn=2 casesCh26Ch42

Following the novel surgical technique using a PreserFlo MicroShunt to control flow in Baerveldt drainage devices, the intraocular pressure (IOP) rose immediately after the procedure and remained well controlled within the targeted range during the first postoperative months without additional pressure-lowering medication in both treated cases.

TreatmentCase seriesn=2 casesCh26Ch28Ch42

The novel surgical technique of inserting a PreserFlo MicroShunt into the lumen of a Baerveldt tube provided predictable flow reductions, according to the Hagen-Poiseuille equation, for treating late hypotony after Baerveldt-shunt implantation.

MechanismCase seriesn=2 casesCh2Ch42

This novel surgical approach using a PreserFlo MicroShunt to modulate outflow resistance in a Baerveldt tube offers a valuable alternative to permanent tube ligation for managing late hypotony after Baerveldt-shunt implantation.

TreatmentExpert OpinionCase seriesn=2 casesCh26Ch42

In the first case of late postoperative hypotony after Baerveldt-shunt implantation, a PreserFlo MicroShunt was inserted through the distal opening of the Baerveldt tube in the anterior chamber to modulate outflow resistance.

TreatmentCase seriesn=1 caseCh26Ch42

In the second case of late postoperative hypotony after Baerveldt-shunt implantation, an end plate, sided approach was chosen after opening the conjunctiva for the insertion of a PreserFlo MicroShunt into the Baerveldt tube.