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Inferonasal placement of glaucoma implant helpful for some cases

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Inferonasal placement of a glaucoma drainage implant “appears to be a safe and effective surgical option that may be helpful in certain clinical situations,” according to a group of researchers.

Kara Hoffman Harbick, MD, and colleagues reviewed the charts of 182 eyes of 182 patients who underwent inferonasal placement of a Baerveldt glaucoma implant. Main outcome measures included IOP, the number of glaucoma medications needed, best corrected visual acuity and complications. Patients were followed for an average 19 months.

The median visual acuity was unchanged at the final follow-up. IOP was reduced from a mean of 28.6 mm Hg to 13.4 mm Hg. The number of glaucoma medications was also reduced, from 1.3 preoperatively to 1.1 at the last follow-up. Nineteen eyes met criteria for failure, with the most common complications being hyphema (14 eyes), choroidal effusion (12 eyes) and corneal decompensation (19 eyes). Endophthalmitis occurred in one eye and diplopia occurred in three eyes.

Cumulative survival was 92% at 12 months, 88% at 24 months and 77% at 44 months.

The study is published in the February issue of the Journal of Glaucoma.