Skip to main content
main-content

03.01.2019 | Glaucoma | Ausgabe 4/2019

Graefe's Archive for Clinical and Experimental Ophthalmology 4/2019

Efficacy of a Novel Retrobulbar Extension Shunt to Rescue Eyes with Fibrotic Encapsulated Blebs and Uncontrolled Ocular Hypertension

Zeitschrift:
Graefe's Archive for Clinical and Experimental Ophthalmology > Ausgabe 4/2019
Autoren:
William E. Sponsel, Sylvia Groth, Francesc March de Ribot, Hannia Ramos, Madeleine Puig

Abstract

Purpose

Retrobulbar glaucoma shunts are large-bore fenestrated silicone stents that redirect aqueous humor into the retrobulbar space. They were designed to rescue failed standard tube shunts with fibrotic encapsulation in patients with intractable ocular hypertension. This article evaluates longer-term outcomes of a larger population undergoing retrobulbar aqueous redirection.

Methods

Outcomes of all retrobulbar shunts were placed among this progressive-entry surgical population over an 8-year interval. Implants were produced by New World Medical (NWM) in Rancho Cucamonga, California, and AJL in Bilbao, Spain. Mean and percentage IOP reduction and medications required were evaluated at annual intervals, along with pre-operative and final visual acuity. Significance of change was assessed by two-tailed paired t-test. Failure was designated as any eye requiring placement of another shunt or diode-cyclophotocoagulation. All data are included in this analysis regardless of outcome.

Results

Thirty-five retrobulbar shunts were implanted (18M, 17F; mean 54.3 years; mean follow-up 32.5 months). Short-term AJL shunt performance was comparable to that of the 26 NWM shunts, for which there was longer-term follow-up. Three shunts (9%) failed: Two eyes required diode at 6 months, one another standard shunt after > 2 years. Preoperative medications averaged 2.6, reduced to 0.4–0.75 medications at each annual assessment (P < 0.0001). IOP was substantially reduced (by 53–57% from mean baseline 29.9–32.5 mmHg to 16.4–18.4 mmHg; P < 0.0008) at every annual follow-up. Visual acuity remained stable (baseline mean VA 0.27, final VA 0.30; P = 0.68).

Conclusion

Retrobulbar extension shunts can convert tube shunt failures, with high success rate, to eyes with IOP control comparable to successful primary filtration surgery.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 4/2019

Graefe's Archive for Clinical and Experimental Ophthalmology 4/2019 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

01.03.2019 | Leitlinien, Stellungnahmen und Empfehlungen | Ausgabe 4/2019

Empfehlungen bei progredienter Myopie im Kindes- und Jugendalter

Stellungnahme von DOG und BVA. Stand Dezember 2018

19.02.2019 | Refraktionsfehler | CME | Ausgabe 3/2019 Open Access

Astigmatismus