Reversible Venting Stitch for Fenestrating Valve-less Glaucoma Shunts. Issue 12 (December 2017)

• Record Type: Journal Article
• Authors: Akil, Handan; Vu, Priscilla Q.; Nguyen, Anhtuan H.; Nugent, Alexander; Chopra, Vikas; Francis, Brian A.; Tan, James C.
• Is Part Of: Journal of glaucoma. Volume 26:Issue 12(2017)
• Publication Date: 2017-12
• Subjects: intraocular pressure -- glaucoma -- glaucoma shunt implant -- venting stitch; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000000784
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Purpose: The purpose of this is to describe a venting stitch modification for valveless glaucoma aqueous shunts and characterize early postoperative intraocular pressure (IOP) and glaucoma medication use following the modification. Materials and Methods: Retrospective chart review of 61 sequential patients undergoing Baerveldt glaucoma implant (BGI)-350 implantation at the Doheny Eye Institute. Twenty-four patients received a glaucoma shunt with venting stitch modification (modified BGI) and 37 patients received an unmodified shunt (BGI-only). IOP, number of glaucoma medications, and number of hypotony cases (intraocular pressure ⩽5 mm Hg) were compared between the groups. T-tests were used for statistical analysis. Results: At postoperative-day 1, mean IOP was significantly lower compared with preoperatively in the modified BGI group (14 mm Hg; reduced by 51%; P <0.0001) but not the BGI-only group (27 mm Hg; P =0.06). IOP difference between groups persisted till immediately before tube opening ( P =0.005) and fewer IOP-lowering medications needed in the modified BGI group ( P <0.0001). One case (4.2%) of postoperative hypotony was encountered with BGI modification, which resolved after the stitch was removed in clinic. Conclusions: The venting stitch valveless shunt modification allows for effective, reliable, and safe control of early postoperative IOP. Abstract : Supplemental Digital Content is available in the text.