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Masaki Tanito, Ichiya Sano, Yoshifumi Ikeda, Etsuko Fujihara
Purpose: To report the results using an ologen Collagen Matrix as a patch graft in eyes with tubal exposure after tube shunt surgery. Case Reports: Case 1 was an 82-year-old man with tubal exposure in his right eye 26 months after receiving a Baerveldt glaucoma implant. The tube was covered by surrounding conjunctival tissue combined with subconjunctival placement of an ologen Collagen Matrix as a patch graft. Two years after implantation, the tube was not exposed...
January 2018: Case Reports in Ophthalmology
Vivian L Qin, Mona Kaleem, Felipe F Conti, Edward J Rockwood, Annapurna Singh, Shalini Sood-Mendiratta, Jonathan E Sears, Fabiana Q Silva, Jonathan Eisengart, Rishi P Singh
PURPOSE: To compare long-term surgical outcomes and complications of pars plana (PP) tube implantation with conventional anterior chamber (AC) tube implantation. MATERIALS AND METHODS: Records of patients undergoing glaucoma tube implant surgery at a single institution between 2007 and 2015 were retrospectively reviewed. Eyes were matched for glaucoma diagnosis and patient age. Demographics, baseline characteristics, and treatment outcomes were recorded. Surgical success was defined as intraocular pressure (IOP) between 6 and 21 mm Hg, no subsequent glaucoma surgeries performed, and at least light perception vision...
May 2018: Journal of Glaucoma
Michelle Go, J Niklas Ulrich, David Fleischman
Purpose: To report a rare complication of non-valved glaucoma drainage device surgery. Observations: An 85-year-old pseudophakic white male presented with painless vision loss and bloody tears. He was 5 weeks removed from uncomplicated non-valved glaucoma drainage device (Baerveldt 101-350, [AMO, Santa Clara, CA]). There was serosanguinous discharge without apparent source and a 25% layering hyphema in the anterior chamber. The tube was unobstructed in the anterior chamber and not abutting the iris...
April 2017: American Journal of Ophthalmology Case Reports
André Rosentreter, Alexandra Lappas, Randolf Alexander Widder, Maged Alnawaiseh, Thomas Stefan Dietlein
BACKGROUND: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). METHODS: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva...
February 27, 2018: BMC Ophthalmology
Steven J Gedde, William J Feuer, Wei Shi, Kin Sheng Lim, Keith Barton, Saurabh Goyal, Iqbal I K Ahmed, James Brandt
PURPOSE: To report 1-year treatment outcomes in the Primary Tube Versus Trabeculectomy (PTVT) Study. DESIGN: Multicenter, randomized clinical trial. PARTICIPANTS: Two hundred forty-two eyes of 242 patients with medically uncontrolled glaucoma and no previous incisional ocular surgery, including 125 in the tube group and 117 in the trabeculectomy group. METHODS: Patients were enrolled at 16 clinical centers and assigned randomly to treatment with a tube shunt (350-mm2 Baerveldt glaucoma implant) or trabeculectomy with mitomycin C (MMC; 0...
May 2018: Ophthalmology
Carla J Osigian, Sara Grace, Maria P Fernandez, Camila V Ventura, Susan Azar, Ta C Chang, Elizabeth Hodapp, Sander R Dubovy, Audina Berrocal
Purpose: Retinal changes secondary to hypotony are usually described as wrinkling or folding of the inner portion of the choroid, the retinal pigment epithelium (RPE), and the outer retinal layers in the macular area due to scleral wall collapse. We describe a new retinal finding in children with suspected hypotony after implantation of Baerveldt Glaucoma Implant (BGI). Observations: Four patients in our series developed significant RPE defects after BGI implant...
March 2018: American Journal of Ophthalmology Case Reports
Wenzhen Zuo, Mark R Lesk
PURPOSE: The purpose of this study was to describe the surgical technique and outcomes in eyes that underwent surgery to replace a failed Ahmed valve by a Baerveldt glaucoma implant in the same quadrant. METHODS: This study was a retrospective case series of 9 patients. Parameters analyzed include age, glaucoma type, prior surgery, complications, intraocular pressure (IOP), visual acuity, and number of glaucoma medications before and after the surgery. Surgical success was defined as having either an IOP below 21 mm Hg or a 20% IOP reduction, with or without hypotensive agent...
May 2018: Journal of Glaucoma
Daniel Laroche, Chester Ng, Giselle Lynch
PURPOSE: To describe a new surgical technique for refractory glaucoma with failed XEN gel stent surgery with insertion of the Baerveldt implant. SURGICAL TECHNIQUE: In a patient with a failed XEN gel stent, a gentle conjunctival dissection was performed to expose the XEN and remove subconjunctival obstruction thus restoring patency and flow. A Baerveldt 250 implant was inserted in the superonasal quadrant above the extraocular muscles and sutured to the sclera. The Baerveldt tube was correctly positioned to accept insertion of the present XEN gel stent...
April 2018: Journal of Glaucoma
Kathleen L Graham, Evelyn J S Hall, Charles Caraguel, Andrew White, Francis A Billson, F Mark Billson
OBJECTIVE: To compare outcomes following trans-scleral cyclophotocoagulation (TSCP) and 350-mm2 Baerveldt implantation in the treatment of canine refractory glaucoma. DESIGN: Retrospective case study. CASE SELECTION: Client owned dogs undergoing surgical treatment of glaucoma within a veterinary referral hospital. PROCEDURES: Eighty-six glaucoma surgeries were performed on 83 eyes (69 dogs) diagnosed with primary or secondary glaucoma...
January 31, 2018: Veterinary Ophthalmology
Arkadiy Yadgarov, Alicia Menezes, Adam Botwinick, Robert A Fargione, Kateki Vinod, Paul A Sidoti, Joseph F Panarelli
PURPOSE: To evaluate the efficacy and safety of a tube fenestration stented with a 10-0 polyglactin suture for controlling early postoperative intraocular pressure (IOP) after Baerveldt glaucoma implant (BGI) surgery. METHODS: The medical records of 110 patients (119 eyes) who underwent BGI surgery with a tube fenestration stented with a 10-0 polyglactin suture anterior to an occlusive tube ligature were retrospectively reviewed. Main outcome measures included IOP and number of glaucoma medications at postoperative day 1, week 1, and weeks 2 to 3 as well as complications occurring before ligature release...
March 2018: Journal of Glaucoma
Kin Sheng Lim
Avoidance of hypotony in the early post-operative phase following glaucoma drainage device surgery is paramount, if serious complications are to be avoided. Current strategies of preventing early hypotony are either a valve mechanism, as those found in Ahmed Glaucoma Valve or flow restrictor as used in Baerveldt or Molteno implants. The Ahmed glaucoma valve has a pre-tensioned valve which opens and closes at the pre-determined level of intra-ocular pressure. Although the opening and closing pressure can be slightly inconsistent, coinciding with the change of material used in the plate construction, the reliability appears to have improved in recent years...
February 2018: Eye
Shunsuke Nakakura, Asuka Noguchi, Santaro Noguchi, Yuka Hirose, Koji Niimi, Hitoshi Tabuchi, Yoshiaki Kiuchi
We report a case of glaucoma implant tube lumen obstruction visualized with anterior segment optical coherence tomography (ASOCT) and present its surgical management. The patient was a 66-year-old man with refractory glaucoma associated with traumatic aphakia in the right eye after trabeculectomy, several bleb needling procedures, and scleral fixation of the intraocular lens with pars plana vitrectomy. Finally, we performed Baerveldt implantation at the pars plana of the temporal inferior quadrant with a several Sherwood slit...
March 2018: Journal of Glaucoma
Van Nguyen, Mason Schmutz, Sarah Farukhi, Sameh Mosaed
We report the case of a 69-year-old female who underwent a Baerveldt implant placement for severe-stage primary open-angle glaucoma and developed a bacterial infection of the conjunctiva and abscess of the scleral patch graft with subsequent tube exposure. The infection was identified 3 weeks postoperatively and a topical antibiotic was immediately initiated. A concurrent systemic staphylococcal infection was discovered by an outside physician and oral cephalexin was initiated. Despite antibiotic treatment, the conjunctival erosion progressed, and tube revision was required...
September 2017: Case Reports in Ophthalmology
Steven J Gedde, Philip P Chen, Dale K Heuer, Kuldev Singh, Martha M Wright, William J Feuer, Joyce C Schiffman, Wei Shi
PURPOSE: To describe the methodology of the Primary Tube Versus Trabeculectomy (PTVT) Study. DESIGN: Multicenter randomized clinical trial. PARTICIPANTS: Patients with medically uncontrolled glaucoma and no prior incisional ocular surgery. METHODS: Patients are being enrolled at 16 clinical centers and randomly assigned to treatment with a tube shunt (350-mm2 Baerveldt glaucoma implant) or trabeculectomy with mitomycin C (0...
December 13, 2017: Ophthalmology
Mohamad El Wardani, Ciara Bergin, Kenza Bradly, Eamon Sharkawi
AIM: To examine the efficacy and safety of Baerveldt tube (BT) implantation compared with combined phacoemulsification and Baerveldt tube (PBT) implantation in patients with refractory glaucoma. METHODS: Seventy-six eyes of 76 patients were enrolled, 38 pseudophakic eyes underwent BT implantation alone and 38 phakic eyes underwent the BT implantation combined with phacoemulsification. Groups were matched for preoperative intraocular pressure (IOP) and number of glaucoma medications...
December 15, 2017: British Journal of Ophthalmology
Jorge A Alvarado, Vinita Srivastava, Yang Sun
PURPOSE: To describe and characterize a novel observation of intraluminal deposits of glaucoma tube shunts (TS) using spectral domain (SD) ocular coherence topography (OCT). PATIENTS AND METHODS: Fifteen TS in 11 patients diagnosed with primary open-angle, neovascular, aphakic, and uveitic glaucomas. Both Ahmed (n=11) and Baerveldt (n=4) TS were examined with 5-line raster anterior segment SD-OCT imaging. RESULTS: The exposed tubes of 2 patients had highly reflective intraluminal deposits in the corresponding exposed areas...
March 2018: Journal of Glaucoma
Alon Zahavi, John R Grigg
PURPOSE: To describe a novel technique for tissue dissection during Baerveldt tube surgery. METHODS: We present a technique for posterior dissection of conjunctiva and Tenon tissue for the placement of a glaucoma drainage device. Hyaluronidase is used in the early stages of surgery in order to minimize tissue trauma and facilitate easy dissection even through existing adhesions and conjunctival scarring. RESULTS: The technique facilitates convenient dissection through tissues...
October 16, 2017: European Journal of Ophthalmology
Richa Gupta, Surabhi Gupta
No abstract text is available yet for this article.
January 2018: Journal of Glaucoma
Handan Akil, Priscilla Q Vu, Anhtuan H Nguyen, Alexander Nugent, Vikas Chopra, Brian A Francis, James C Tan
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)...
December 2017: Journal of Glaucoma
Tigran Kostanyan, Tarek Shazly, Kevin B Kaplowitz, Steven Z Wang, Sushma Kola, Eric N Brown, Nils A Loewen
PURPOSE: To apply propensity score matching to compare Baerveldt glaucoma drainage implant (BGI) to Trabectome-mediated ab interno trabeculectomy (AIT). Recent data suggests that AIT can produce results similar to BGI which is traditionally reserved for more severe glaucoma. METHODS: BGI and AIT patients with at least 1 year of follow-up were included. The primary outcome measures were intraocular pressure (IOP), number of glaucoma medications, and a Glaucoma Index (GI) score...
December 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
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