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Glaucoma drainage device

Mark Yu-Ming Chiang, Jayne E Camuglia, Peng Tee Khaw
PURPOSE: To describe a new and simple technique of glaucoma tube extension that carries several advantages over previously described techniques. PATIENTS AND METHODS: A retrospective noncomparative case series of 3 patients (1 adult and 2 pediatric cases) with glaucoma tube retraction managed by the "tube-in-tube" technique. The follow-up duration ranges from 1 month to 3 years. RESULTS: Adequate tube position and length were seen in all cases throughout the follow-up period...
October 14, 2016: Journal of Glaucoma
Davinder S Grover, David G Godfrey, Oluwatosin Smith, Wei Shi, William J Feuer, Ronald L Fellman
PURPOSE: To report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior incisional glaucoma surgery. PATIENTS AND METHODS: A retrospective review was performed for all patients who underwent a GATT procedure with a history of prior incisional glaucoma surgery. RESULTS: Thirty-five eyes of 35 patients were treated. The mean age was 67.7 years. Nineteen eyes had a prior trabeculectomy, 13 eyes had a prior glaucoma drainage device, 4 eyes had a prior trabectome, and 5 eyes had prior endocyclophotocoagulation...
October 6, 2016: Journal of Glaucoma
Jea H Yu, Chuck Nguyen, Esmeralda Gallemore, Ron P Gallemore
Purpose. To report a new technique for anterior placement of tubes for glaucoma drainage devices to reduce the risk of tube erosions. Methods. Retrospective review of select cases of Ahmed Valve surgery combined with the novel method of a limbal-based scleral flap covered by a scleral patch graft to cover the tube at the entrance through the limbus. Intraoperative and postoperative illustrations are shown to highlight the method of tube placement. Results. In this retrospective case series, 3 patients are presented illustrating the technique...
2016: Case Reports in Ophthalmological Medicine
Jianjun Gu, Jiajie Zhai, Guiqing Liao, Jiaqi Chen
PURPOSE: To describe the results of Boston keratoprosthesis implantation in a patient with Stevens-Johnson syndrome following autologous submandibular gland transplantation. DESIGN: Observational case report. METHODS: We report the case of a man diagnosed with Stevens-Johnson syndrome. Autologous submandibular gland transplantation was performed in the right eye in 2008 to ameliorate tear film deficiency. Due to the improvement in the microenvironment of the ocular surface, Boston keratoprosthesis implantation was performed in the right eye in 2011...
October 11, 2016: Ocular Immunology and Inflammation
Avik Kumar Roy, Sirisha Senthil
Objective: To describe the management options for exposed silicone Ahmed glaucoma valve (AGV) implant. Methods: This was carried out as a retrospective chart review at a tertiary care eye hospital in Southern India. Medical records of six subjects managed for AGV exposure from 2006 to 2013 were reviewed. Results: All six eyes had explantation of the AGV and 3 of them had reimplantation in a different quadrant at a later date and the other 3 eyes were managed medically. All eyes had well controlled IOP at the last follow-up...
2016: GMS Ophthalmol Cases
Elisa D'Alessandro, Jacopo M Guidotti, Kaweh Mansouri, André Mermoud
BACKGROUND: Glaucoma drainage devices have traditionally been reserved for patients with refractory glaucoma. However, these devices are prone to various sight-threatening complications. To prevent hypotony after placement of the Baerveldt tube, surgeons traditionally tie the tube with an absorbable suture until encapsulation occurs around the plate. We hypothesized that combining the XEN tube, placing it in the anterior chamber and connecting it to the Baerveldt tube posteriorly, outside the anterior chamber, would minimize 2 main potentially blinding complications: hypotony and corneal disease...
September 21, 2016: Journal of Glaucoma
Ana L Perez-Balbuena, David Ancona-Lezama, Jaime D Martinez, Sarai Delgado-Pelayo
PURPOSE: The aim of this study is to expand the limited knowledge regarding autologous contralateral penetrating keratoplasty. METHODS: We report the retrospective outcomes of patients who received autokeratoplasty and contralateral opaque corneas in the donor eye at a tertiary care ophthalmology hospital in Mexico City. RESULTS: Eleven patients received autokeratoplasty and contralateral opaque corneas in the donor eye at our center from 2010 to 2015...
September 21, 2016: Cornea
Tamara L Lenis, Stephan Y Chiu, Simon K Law, Fei Yu, Anthony J Aldave
PURPOSE: To evaluate the safety of concurrent Boston type I keratoprosthesis (KPro) and glaucoma drainage device (GDD) implantation. DESIGN: Retrospective comparative study of a consecutive cohort of patients. SUBJECTS: Patients who underwent KPro implantation by a single surgeon (A.J.A.) with or without 1 concurrent Ahmed GDD (New World Medical, Inc., Rancho Cucamonga, CA) implantation between January 1, 2005, and January 31, 2015, were included...
September 7, 2016: Ophthalmology
J L Olson, S Groman-Lupa
PurposeWe report the in vivo testing of a large-lumen glaucoma drainage (LL-GDD) device equipped with a flow regulator. The device's membrane can be non-invasively opened with laser in the postoperative period to adjust aqueous flow and intraocular pressure.MethodsThe initial LL-GDD prototypes were constructed using 22 G silicone angiocatheters cut down to size. A 10 nm PVDF membrane was then affixed to the end using cyanoacrylate. The LL-GDD was tested first in a model eye equipped with ports for infusion and pressure measurement and in New Zealand rabbits...
September 9, 2016: Eye
Veena S Rao, Joseph Christenbury, Paul Lee, Rand Allingham, Leon Herndon, Pratap Challa
PURPOSE: To evaluate efficacy and safety of a novel technique, simultaneous implantation of Ahmed and Baerveldt shunts, for improved control of intraocular pressure (IOP) in advanced glaucoma with visual field defects threatening central fixation. PATIENTS AND METHODS: Retrospective case series; all patients receiving simultaneous Ahmed and Baerveldt implantation at a single institution between October 2004 and October 2009 were included. Records were reviewed preoperatively and at postoperative day 1, week 1, month 1, month 3, month 6, year 1, and yearly until year 5...
September 2, 2016: Journal of Glaucoma
Yohko Murakami, Handan Akil, Jasdeep Chahal, Laurie Dustin, James Tan, Vikas Chopra, Brian Francis
BACKGROUND: To evaluate the efficacy in controlling intraocular pressure (IOP) with endoscopic cyclophotocoagulation (ECP) versus implantation of a second glaucoma drainage device (GDD-2) in the treatment of uncontrolled glaucoma with a prior aqueous tube shunt. DESIGN: A nonrandomized retrospective chart review. PARTICIPANTS: Patients with refractory glaucoma following a failed initial tube shunt (Baerveldt Glaucoma Implant 350), who underwent ECP or GDD-2 with Baerveldt Glaucoma Implant as a second surgery...
August 28, 2016: Clinical & Experimental Ophthalmology
Daniele Tognetto, Paolo Cecchini, Rossella D'Aloisio, Odilla Vattovani, Gianluca Turco
We report a case of an explanted stainless steel miniature glaucoma drainage device (EX-PRESS) implanted under a scleral flap for pseudoexfoliation open-angle glaucoma surgical treatment. The glaucoma shunt was implanted in a 75-year-old white man with medically refractive glaucoma. Cataract surgery was performed simultaneously. After 2 years, the shunt extruded through the scleral flap and the conjunctiva and it was, therefore, explanted. Scanning electron microscopy images of the EX-PRESS mini glaucoma shunt were acquired to verify the patency of the device lumen and the presence of fibrosis or cellular adhesion on the device...
August 22, 2016: Journal of Glaucoma
Shikha Gupta, Abadh K Chaurasia, Rohan Chawla, Kulwant Singh Kapoor, Karthikeyan Mahalingam, Deepa R Swamy, Viney Gupta
PURPOSE: To evaluate long-term success of the Ahmed glaucoma valve (AGV) for refractory glaucoma after vitreoretinal surgery with silicone oil insertion. METHODS: Prospective non-comparative evaluation of patients who underwent AGV insertion for management of post-vitreoretinal surgery glaucoma, post-silicone oil removal. Intraocular pressure (IOP), visual acuity, and glaucomatous neuropathy status were evaluated preoperatively and at multiple follow-up visits postoperatively...
August 18, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Annelie N Tan, Carroll A B Webers, Tos T J M Berendschot, John de Brabander, Pauline M de Witte, Rudy M M A Nuijts, Johannes S A G Schouten, Henny J M Beckers
PURPOSE: To investigate central and peripheral corneal endothelial cell density (ECD) in relation to Baerveldt (BV) glaucoma drainage device (GDD) tube corneal (TC) distance. METHODS: Prospective study of all patients scheduled for glaucoma tube surgery with 36 months follow-up. A BV GDD was inserted into the anterior chamber (AC). Anterior segment optical coherence tomography (AS-OCT) scans were made to determine the TC distance. Central and peripheral ECD was measured, preoperatively and at 3, 6, 12, 24 and 36 months postoperatively...
August 6, 2016: Acta Ophthalmologica
A Rosentreter, T S Dietlein
Episcleral glaucoma drainage devices (e.g., Ahmed or Baerveldt drainage device) are often used at a late stage in the care of glaucoma patients. At this stage other surgical techniques, such as trabeculectomy or viscocanaloplasty, have failed. However, the trend towards earlier implant surgery is supported by large randomized trials. Physicians should be aware of typical complications and, if possible, these should already be avoided by careful surgical technique. In this review article, we focus on postoperative hypotension, postoperative pressure increases, implant exposure, and possible corneal decompensation...
July 25, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Abdulaziz AlHadlaq, Salem AlMalki, Sami AlShahwan
We report an extremely rare presentation of late-onset endophthalmitis in a young adult patient with an unexposed Ahmed tube implant. The implant was inserted 11 years prior to presentation. There was no history of trauma or any obvious exposure on clinical examination and the tube plate was filled with purulent material. After aqueous and vitreous tap, the patient underwent intracameral, intravitreal subconjunctival antibiotic injections and was started on systemic antibiotics with good response. Endophthalmitis associated with tube drainage device can present as late as 11 years and even without an unexposed tube...
April 2016: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Demetrios T Manasses, Leon Au
Minimally invasive glaucoma surgery (MIGS) has been gaining popularity over the last decade. Although there is no strict definition for MIGS, all the new procedures share the common theme of intraocular pressure reduction with minimal tissue destruction, short surgical time, simple instrumentation and fast postoperative recovery. The use of glaucoma drainage implants has long been the traditional treatment for complex glaucoma, but a new wave of glaucoma micro-stents are now being manufactured with various materials designed to increase aqueous outflow via different channels...
June 17, 2016: Ophthalmology and Therapy
Kevin A Blackney, Zachary J Zavodni, Daniel Saddawi-Konefka
The pathophysiology of glaucoma and perioperative visual loss is similar. A patient with glaucoma may be at increased risk of perioperative visual loss. For both, goals of management include optimizing ocular perfusion pressure and oxygen delivery. One treatment for refractory glaucoma is an aqueous drainage device; however, there is no published literature on the anesthetic management of patients with these devices. We present the case of a patient with recalcitrant glaucoma treated with an Ahmed Glaucoma Valve who underwent urgent prone surgery...
August 1, 2016: A & A Case Reports
Frederick A Jakobiec, Durga S Borkar, Anna M Stagner, Nahyoung Grace Lee
IMPORTANCE: Medulloepithelioma is the second most common primary neuroepithelial tumor of the eye. The full range of its morphologic expressions and appearances in metastases have not been fully explored. OBSERVATIONS: A patient in her 50s with glaucoma for decades had undergone multiple filtering surgical procedures, including the placement of a glaucoma drainage device. A paraspinal mass was discovered, and tumor and bone marrow biopsies disclosed rhabdomyosarcoma...
August 1, 2016: JAMA Ophthalmology
Omair B Ali, Ryan Deroque, R Grant Morshedi, Harry Brown
PURPOSE: Conjunctival biopsies may contain polarizable material in patients with sarcoidosis despite no history of prior trauma or eye surgeries. PROCEDURES: A 39-year-old male with uveitic glaucoma presented with decreased vision and throbbing pain in his right eye. His intraocular pressure was elevated, and his vision was reduced to hand motion. Due to persistently elevated intraocular pressure refractory to medical treatment, the patient underwent a glaucoma drainage device procedure...
April 2016: Ocular Oncology and Pathology
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