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Shunt lowers IOP after irradiation in eyes with anterior uveal melanoma
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Baerveldt shunts reduced IOP in eyes that underwent previous anterior segment irradiation for anterior uveal melanoma, according to a study.
“Anterior uveal melanoma affecting the iris or ciliary body is less common than choroidal melanoma. However, due to the close anatomical relationship of [anterior uveal melanoma] to the trabecular meshwork, it is more commonly associated with elevated intraocular pressure,” the study authors said.
The prospective study included 31 eyes with uncontrolled IOP after undergoing proton beam radiotherapy for anterior uveal melanoma. All eyes subsequently underwent Baerveldt shunt implantation.
Surgical success was based on IOP of 21 mm Hg or less and a reduction in IOP of at least 20% from baseline without medications.
Mean follow-up was 15.7 months; the mean time span between irradiation and shunt implantation was 2.5 years.
Mean IOP decreased from 31 mm Hg preoperatively to 15 mm Hg at the last visit. The mean reduction in IOP from baseline to all postoperative examinations was statistically significant (P < .05).
The success rate was 86% with glaucoma medications and 50% without medications at 12 months. IOP was higher than 21 mm Hg in one eye in which treatment was deemed a failure.
Mean glaucoma medications decreased from 3.3 preoperatively to 0.7 postoperatively. Medication use diminished sharply after stent removal at a mean 17.5 weeks after surgery.
The increase in mean visual acuity was statistically insignificant.
No intraoperative complications were recorded; postoperative complications occurred in four eyes, the authors said.
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