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Suprachoroidal space is good target for aqueous in glaucoma

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LAS VEGAS — To improve aqueous outflow in glaucoma, the suprachoroidal space provides many advantages over the subconjunctival space as a target site for aqueous diversion, according to a speaker here.

Robert D. Fechtner, MD, FACS, said the subconjunctival space is a "dreadful" target for aqueous diversion, despite the popularity of trabeculectomy, because it results in poor cosmesis, a lifetime risk of endophthalmitis and an unpredictable wound-healing response. He proposed using the suprachoroidal space instead, as it is a normal route for aqueous outflow and heals more predictably.

At the Glaucoma Subspecialty Day preceding the American Academy of Ophthalmology meeting, Dr. Fechtner described results using the Solx Gold Micro-Shunt, which is designed to divert aqueous to the suprachoroidal space.

In a nonrandomized study of 76 eyes with a mean preop IOP of 27.5 mm Hg, treatment with the Gold Micro-Shunt resulted in a 37% mean reduction in IOP at 24 months' follow-up, Dr. Fechtner said.

No severe hypotony or suprachoroidal hemorrhages were seen in the study, he said.