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Kateki Vinod, Joseph F Panarelli, Ronald C Gentile, Paul A Sidoti
PURPOSE OF THE STUDY: The purpose of the study was to report long-term outcomes and complications of Baerveldt glaucoma implant (BGI) surgery with pars plana tube insertion in children. MATERIALS AND METHODS: The medical records of consecutive aphakic and pseudophakic children (<16 y of age) who underwent BGI surgery with pars plana tube insertion between 1990 and 2013 were retrospectively reviewed. Main outcome measures were intraocular pressure and number of glaucoma medications...
December 20, 2016: Journal of Glaucoma
Daniel E R Beck, Karim S L El-Assal, Mark D Doherty, Nicholas K Wride
PURPOSE: To date, there have only been 5 reported cases of orbital cellulitis following implantation of an aqueous tube shunt for glaucoma. Previously reported cases have involved eyes with significant comorbidities and successful management has often required the removal of the device alongside systemic antibiotic therapy. PATIENTS AND METHODS: We present a 53-year-old man with severe orbital cellulitis, 3 months after routine implantation of a Baerveldt tube shunt for primary open angle glaucoma...
December 20, 2016: Journal of Glaucoma
Philip P Chen
PURPOSE: To describe a new technique to treat late persistent hypotony after Baerveldt glaucoma drainage device surgery. METHODS: Review of 2 cases treated with in situ truncation of one or both wings of the Baerveldt device, combined with permanent but releasable tube occlusion. RESULTS: Two eyes with persistent hypotony underwent in situ truncation of one or both wings of the Baerveldt device with resolution of hypotony. Recurrence of elevated intraocular pressure (IOP) in both cases required reversal of tube occlusion, after which the IOP has remained both well controlled and sufficiently elevated to avoid complications of hypotony over 13 and 43 months...
November 30, 2016: Journal of Glaucoma
Philip Y Sun, David A Leske, Jonathan M Holmes, Cheryl L Khanna
PURPOSE: To report the prevalence, type, and cause of diplopia in medically and surgically treated patients with glaucoma. DESIGN: Cohort study. PARTICIPANTS: A total of 195 adult patients with glaucoma treated in a glaucoma referral practice. METHODS: A total of 195 adult patients with glaucoma who had undergone surgical or medical management were prospectively enrolled. Forty-seven patients had undergone glaucoma drainage device (GDD) surgery (Baerveldt 350, Baerveldt 250 [Abbott Medical Optics, Abbott Park, IL], or Ahmed FP7 [New World Medical Inc, Rancho Cucamonga, CA]), 61 patients had undergone trabeculectomy, and 87 patients were medically treated...
November 18, 2016: Ophthalmology
Kathleen L Graham, David Donaldson, Francis A Billson, F Mark Billson
OBJECTIVE: To evaluate the 350-mm(2) Baerveldt glaucoma drainage device (GDD) in dogs with refractory glaucoma when modifications to address postoperative hypotony (extraluminal ligature; intraluminal stent) and the fibroproliferative response (intraoperative Mitomycin-C; postoperative oral colchicine and prednisolone) are implemented as reported in human ophthalmology. DESIGN: Retrospective case series. ANIMALS: Twenty-eight client-owned dogs (32 eyes) including seven dogs (nine eyes) with primary glaucoma and 21 dogs (23 eyes) with secondary glaucoma...
November 16, 2016: Veterinary Ophthalmology
Ignacio Rodriguez-Una, Augusto Azuara-Blanco, Anthony J King
BACKGROUND: To evaluate the spectrum of glaucoma surgery and the post-operative follow-up regimes undertaken among glaucoma specialists in the United Kingdom. DESIGN: National survey. PARTICIPANTS: Seventy-five glaucoma specialists (consultants and fellows). METHODS: An eight-question survey was emailed to all glaucoma subspecialists members of the United Kingdom and Eire Glaucoma Society. MAIN OUTCOME MEASURES: Surgery undertaken, post-operative management, awareness of intervention tariff and handling of the follow-up burden generated through surgery...
October 11, 2016: Clinical & Experimental Ophthalmology
Yasser M Elshatory, Elizabeth H Gauger, Young H Kwon, Wallace L M Alward, H Culver Boldt, Stephen R Russell, Vinit B Mahajan
PURPOSE: To review the impact of vitrectomy and tube shunts on mean intraocular pressure (IOP) and number of glaucoma medications in pediatric aphakic glaucoma. METHODS: A retrospective review of pediatric patients who underwent combined vitrectomy and glaucoma tube shunt surgery for aphakic glaucoma was conducted. Inclusion criteria were: age 18 years or younger, diagnosis of aphakic glaucoma, preoperative IOP data, and postoperative IOP data for at least 6 months...
November 1, 2016: Journal of Pediatric Ophthalmology and Strabismus
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
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
Mohammad Reza Razeghinejad, Masoumeh Masoumpour, Mohammad Hossein Eghbal, Jonathan S Myers, Marlene R Moster
Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed...
September 2016: Iranian Journal of Medical Sciences
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
Arthur F Resende, Marlene R Moster, Neal S Patel, Daniel Lee, Hermandeep Dhami, Michael J Pro, Michael Waisbourd
PURPOSE: Glaucoma patients with markedly elevated intraocular pressure (IOP) are at risk for developing severe hypotony-related complications. The goal of this study was to compare the surgical outcomes of the Ahmed Glaucoma Valve (AGV) and the Baerveldt Glaucoma Implant (BGI) in this patient population. METHODS: Patients with preoperative IOP≥30 mm Hg were included. Outcome measures were: (1) surgical failure (IOP>21 mm Hg or <30% reduction from baseline or IOP≤5 mm Hg on 2 consecutive follow-up visits after 3 mo, or additional glaucoma surgery, or loss of light perception) and (2) surgical complications...
September 2016: Journal of Glaucoma
Panos G Christakis, Jeffrey W Kalenak, James C Tsai, David Zurakowski, Jeffrey A Kammer, Paul J Harasymowycz, Juan J Mura, Louis B Cantor, Iqbal I K Ahmed
PURPOSE: To compare 2 frequently used aqueous shunts for the treatment of glaucoma. DESIGN: International, multicenter, randomized trial. PARTICIPANTS: Patients aged 18 years or older with uncontrolled glaucoma despite maximum tolerated medical therapy, many of whom had failed or were at high risk of failing trabeculectomy. METHODS: Eligible patients were randomized to receive an Ahmed-FP7 valve implant (New World Medical, Inc, Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc, Santa Ana, CA) using a standardized surgical technique...
October 2016: 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
Abed Namavari, Robert A Hyde, Daniel Wang, Thasarat S Vajaranant, Ahmad A Aref
INTRODUCTION: This study is a retrospective case series to evaluate the outcomes and complications of Baerveldt glaucoma implant surgery (BGI) in patients without prior cataract or incisional glaucoma surgery. METHODS: Patients who underwent 350-mm(2) BGI through the Glaucoma Service of the University of Illinois at Chicago between 2010 and 2015 were included in this study. Outcome measures included age, sex, ethnicity, operated eye, preoperative diagnosis, preoperative, and sequential postoperative intraocular pressure (IOP), visual acuity, glaucoma medications, and postoperative complication and interventions...
December 2016: Ophthalmology and Therapy
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
Shiming Wang, Xiaoming Gao, Nana Qian
BACKGROUND: The purpose of this study was to compare the efficacy and tolerability of the Ahmed glaucoma valve (AGV) implant and the Baerveldt implant for the treatment of refractory glaucoma. METHODS: We comprehensively searched four databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library databases, selecting the relevant studies. The continuous variables, namely, intraocular pressure reduction (IOPR) and a reduction in glaucoma medication, were pooled by the weighted mean differences (WMDs), and the dichotomous outcomes, including success rates and tolerability estimates, were pooled by the odds ratio (ORs)...
June 8, 2016: BMC Ophthalmology
Hye Jin Kwon, Nathan M Kerr, Jonathan B Ruddle, Ghee Soon Ang
Endophthalmitis post glaucoma drainage implant (GDI) surgery is rare, often associated with tube or plate exposure. We report a case of endophthalmitis following glaucoma shunt intraluminal stent exposure in a patient who underwent Baerveldt glaucoma implant surgery. Endophthalmitis following manipulation of intraluminal stents is a rare complication of GDIs but potentially vision threatening condition that needs to be carefully screened for and treated immediately. How to cite this article: Kwon HJ, Kerr NM, Ruddle JB, Ang GS...
January 2016: Journal of Current Glaucoma Practice
T S Dietlein, A Neugebauer, J Fricke, A Lappas, A Rosentreter
There is an increasing trend towards using glaucoma drainage implants. The postoperative management of such devices depends on their technical characteristics and specific complications. The Baerveldt glaucoma implant with its larger surface area has been shown to lower mean intraocular pressure more effectively than the Ahmed-FP7 implant. As a non-valve implant, however, it has been associated with a higher rate of severe complications, particularly ocular hypotension. Moreover, glaucoma implants may induce diplopia if they interfere with extraocular muscles...
May 2016: Klinische Monatsblätter Für Augenheilkunde
Pankaj Kataria, Sushmita Kaushik, Simar R Singh, Surinder S Pandav
BACKGROUNDS: Glaucoma drainage devices create an alternative pathway of aqueous drainage from the anterior chamber by channelling aqueous out of the eye through a tube to a subconjunctival bleb or the suprachoroidal space. They may be associated with a number of potential complications including tube malpositioning. This malpositioning may have serious sequelae such as corneal endothelial damage, chronic iritis, tube iris touch, cataract formation, or tube occlusion. Occlusion of the mouth of the tube by the iris impedes aqueous drainage and results in the failure of intraocular pressure (IOP) control...
August 2016: Journal of Glaucoma
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