Glaucoma drainage implant may reduce IOP, medication use
Eur J Ophthalmol. 2012;22(1):70-76.
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A cross-linked sodium hyaluronate drainage implant controlled IOP after nonpenetrating filtering surgery, a study found.
"The new surgical technique can increase the efficacy and safety of filtering surgery with no need for major changes in the procedure," the study authors said.
The retrospective, nonrandomized study included 55 eyes of 55 patients with medically uncontrolled glaucoma who underwent bilateral deep sclerectomy with the HEALAflow cross-linked sodium hyaluronate device (Anteis). Mean patient age was 67.4 years. Mean preoperative IOP was 21.6 mm Hg and mean number of anti-glaucoma medications was 2.4. Mean preoperative logMAR best corrected visual acuity was 0.8.
Patients were examined preoperatively and 1 day, 1 week, and 1, 3, 6, 12 and 18 months postoperatively. Mean follow-up was 12 months.
The benchmark for complete success was IOP between 6 mm Hg and 18 mm Hg without medication. Qualified success was attainment of the same level of IOP with medication. Overall success was that level of IOP with or without medication.
Study results showed that mean IOP was reduced significantly (P < .005) to 11.5 mm Hg. Mean number of medications was reduced significantly (P < .001) to 0.5. Best corrected visual acuity remained stable.
Complete success was achieved in 70% of patients, and overall success was attained in 91%.
Filtering blebs were visible in 49 eyes. Hypotony was identified in five eyes and iris incarceration was seen in three eyes. Failure occurred in two patients, requiring additional surgery for bleb revision, the authors said.