Suprachoroidal tube drainage may be effective as initial glaucoma treatment

J Glaucoma. 2011;20(5):307-314.

Suprachoroidal tube drainage of aqueous humor may be a preferred initial treatment for glaucoma patients without prior trabeculectomy, a study found.

In the prospective clinical trial, 24 eyes underwent suprachoroidal silicone tube shunt implantation, with drainage from the anterior chamber to the suprachoroidal space. Seven of these eyes had prior trabeculectomy.

An IOP of greater than 21 mm Hg or less than 5 mm Hg at 3 months postop signified procedural failure, as did additional glaucoma surgery. Eyes that did not fail and did not require medical therapy were deemed completely successful; eyes that did not fail but required supplemental therapy were considered qualified successes.

A complete success rate of 63.3% ± 12% was observed at 6 months and 12 months. A qualified success rate of 87.5% ± 6.8% was seen at 1 month, 3 months, 6 months and 12 months. Success was significantly more prevalent among patients without prior trabeculectomy.

Early hypotony was defined as an IOP of less than 5 mm Hg within 4 weeks postop, which was the most common complication, occurring in 25% of eyes. The study authors suggested smaller inner tube diameter, intraoperative filling of the tube lumen with viscoelastic, transient ligation or the use of a valved drainage device to decrease this risk.

Most of the postop complications occurred in the seven eyes that failed, suggesting that early complications may predict unsuccessful surgery, the study authors said.