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Trabecular bypass shunt shows potential for glaucoma surgery

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REGENSBURG, Germany — A device that creates an aqueous bypass of the trabecular meshwork showed promise in a pilot study here. The trabecular meshwork bypass tube shunt effectively lowered intraocular pressure and reduced the number of medications needed in five glaucoma patients, according to a report in the British Journal of Ophthalmology.

Detlev Spiegel, MD, and colleague at the University of Regensburg implanted the shunt in 6 eyes of 5 patients with uncontrolled open-angle glaucoma and no previous ocular surgery. The shunt, measuring 150 µm in outer diameter and 50 µm in inner diameter, directly connects Schlemm’s canal to the anterior chamber.

According to the report, 5 of the 6 eyes were successfully implanted. Follow-up of between 5 months and 9 months on 4 eyes showed no loss of visual acuity and a decrease of mean IOP from 23 mm Hg preoperatively to 17 mm Hg postop. The number of medications was reduced from a mean of 3 to 0.5.

No increased aqueous flare or reduction in endothelial cell counts were noted in a subset of 2 eyes. Two eyes showed a diffuse bleb. Only one tube was explanted due to presumed misplacement.