Reversible Venting Stitch for Fenestrating Valve-less Glaucoma Shunts.
Akil Handan, Vu Priscilla Q, Nguyen Anhtuan H, Nugent Alexander, Chopra Vikas, Francis Brian A, Tan James C
AI Summary
A venting stitch for valveless glaucoma shunts was studied, finding it safely and effectively controls early post-operative IOP, reducing hypotony risk and medication needs.
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.
MeSH Terms
Shields Classification
Key Concepts5
A venting stitch modification for valveless glaucoma aqueous shunts (modified BGI) resulted in a significantly lower mean intraocular pressure (IOP) of 14 mm Hg at postoperative-day 1 compared to preoperatively, representing a 51% reduction (P<0.0001).
The intraocular pressure (IOP) difference between the modified Baerveldt glaucoma implant (BGI) group and the BGI-only group persisted until immediately before tube opening (P=0.005), with fewer IOP-lowering medications needed in the modified BGI group (P<0.0001).
One case (4.2%) of postoperative hypotony was encountered with the Baerveldt glaucoma implant with venting stitch modification, which resolved after the stitch was removed in clinic.
In patients receiving an unmodified Baerveldt glaucoma implant (BGI-only), the mean intraocular pressure (IOP) at postoperative-day 1 was 27 mm Hg, which was not significantly different compared to preoperatively (P=0.06).
A retrospective chart review of 61 sequential patients undergoing Baerveldt glaucoma implant (BGI)-350 implantation at the Doheny Eye Institute was conducted to compare outcomes between a modified BGI with a venting stitch (24 patients) and an unmodified shunt (37 patients).
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