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Alternative technique for drainage device implantation could limit complications
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Inserting a glaucoma drainage device in the posterior chamber sulcus rather than in the anterior chamber can be effective for controlling IOP, a retrospective study found. The technique may also reduce endothelial cell loss and the need for pars plana vitrectomy, the study authors noted.
Celso Tello, MD, and colleagues at the New York Eye and Ear Infirmary reviewed the results of a new technique to implant a Baerveldt glaucoma implant (Advanced Medical Optics).
The study included eight eyes of eight patients who averaged 76 years of age; four patients had primary open-angle glaucoma, two had exfoliative glaucoma, one had neovascular glaucoma and one had developed glaucoma after penetrating keratoplasty, according to the study.
The researchers found that IOP reduced from an average of 28 mm Hg preoperatively to 12 mm Hg at 18 months postop. The mean number of medications required to control IOP also reduced, from 2.8 drugs preoperatively to 1.3 drugs at 18 months follow-up, according to the study.
"Sulcus implantation is at least comparable to the standard insertion into the anterior chamber or the more time-consuming and complicated pars plana tube insertion," they said.
There were no complications during surgery or the follow-up period, the authors noted.
"Implantation of a glaucoma tube shunt into the posterior chamber sulcus may minimize the deleterious effects of anterior chamber placement and avoid the complications associated with surgical vitrectomy during pars plana insertion," they said.
The study is published in the June issue of the British Journal of Ophthalmology.