Novel Glaucoma Surgical Devices (original) (raw)
Related papers
Glaucoma drainage devices: a systematic literature review and current controversies
Survey of Ophthalmology, 2005
Glaucoma drainage devices create alternate aqueous pathways by channeling aqueous from the anterior chamber through a long tube to an equatorial plate that promotes bleb formation. Glaucoma drainage devices are being used more frequently in the treatment of glaucoma that does not respond to medications or trabeculectomy operations. In certain conditions, such as neovascular glaucoma, iridio-corneal syndrome, penetrating keratoplasty with glaucoma, glaucoma following retinal detachment surgery, and so on, it is becoming the primary operation. This review provides a systematic review of the literature and outlines the current controversies involving different glaucoma drainage devices and their design, overall surgical success, and complications following glaucoma drainage device insertion.
Revista Brasileira de Oftalmologia
Glaucoma drainage devices are important therapeutic options for cases of refractory glaucoma, in which trabeculectomy with antimetabolites has shown high risk of failure. There are devices with different sizes, designs and materials, and several studies have been conducted to test their safety and effectiveness. Despite known complications, their use has progressively increased in recent years, and they are the primary surgical option, in some situations. The aim of this review is to discuss the importance, mechanisms, biomaterials, results and complications of glaucoma drainage devices. RESUMO Os dispositivos de drenagem para glaucoma são importante opção terapêutica em casos de glaucomas refratários, nos quais a trabeculectomia com antimetabólitos tem alta chance de falência. Há dispositivos com diferentes tamanhos, desenhos e materiais, e muitos estudos foram realizados para testar sua segurança e eficácia. Apesar de suas conhecidas complicações, seu uso tem aumentado progressivamente nos últimos anos, inclusive como primeira opção cirúrgica, em algumas situações. O objetivo desta revisão foi discutir a importância, os mecanismos, os biomateriais, os resultados e as complicações dos dispositivos de drenagem para glaucoma.
Glaucoma Drainage Device (GDD) Implantation in Post Trabeculectomy Patients
International Journal Of Scientific Advances
Objective: This study aims to report a case of Glaucoma Drainage Device (GDD) implant surgery in a patient who experienced an increase in Intraocular Pressure (IOP) after long term trabeculectomy. Case Presentation: A 58-year-old male patient came with complaint of blurred vision since two years ago. Patient did not complain of sore and red eyes. He was given 2 x 250 mg of Acetazolamide, 2 x 1 tablet of Aspar K, 2 x 1 right and left eye (RLE) of Latanoprost, and 2 x 1 RLE of Betaxolol HCl. The patient had glaucoma since 20 years ago and had undergone surgery in 2002 on the right eye and left eye surgery in 2004. His right eye intraocular pressure was 38 mmHg with conjungtival bleb (+) flat (+) minimal vascularity (+) horizontal extent 1-2 clock hours. Patient then underwent a GDD implant surgery on the right eye, IOP 8 mmHg post GDD. Three months after surgery, the visual acuity decrease into 6/120 ph 6/21, elevated IOP into 32 with prominent lens opacity, so the phacoemulsification...
The Choice of Drainage Device in Complicated Glaucomas: Comparing Ahmed and Baerveldt Implants
In Vivo
Background/Aim: Glaucoma is a chronic and progressive optic neuropathy which leads to deterioration of visual function. It is estimated to be the second leading cause of severe vision loss and blindness worldwide. Failure of antiglaucoma medication to sufficiently reduce intraocular pressure (IOP) and poor compliance with medication are indications for glaucoma surgery, for example using glaucoma drainage devices. Our aim was to compare the surgical outcomes following the implantation of Ahmed FP7 and Baerveldt 350 drainage devices. Patients and Methods: Five hundred and fiftytwo patients with primary or secondary glaucoma were enrolled in the study. All patients had a history of failed trabeculectomy or other intraocular surgery, and IOP ≥18 mm Hg. The implantation of Ahmed (266 patients) or Baerveldt (286 patients) devices was randomly performed in the patients, who were subsequently examined for a period of 5 years. Follow-up visits were scheduled 1 day; 1 week; 1, 3 and 6 months; and 1, 1.5, 2, 3, 4 and 5 years postoperatively. Results: Significant reduction of IOP was achieved in both groups. Ahmed valve (28.3±9.3, 13.4±6.9, 14.2±6 and 12.7±4.5 mmHg at baseline, 1, 3, and 5 years postoperatively, respectively) resulted in significantly greater IOP reduction compared to Baerveldt implant (29.6±10.1, 15.4±5.5, 14.5±5.5 and 14.7±4.4 mmHg at baseline, 1, 3, and 5 years postoperatively, respectively). A significantly lower number of medications was required in the Ahmed group in comparison to the Baerveldt one (Ahmed group: 1.5±1.4, 1.4±1.5 and 1.8±1.5; Baerveldt group: 1.9±1.3, 1.9±1.3 and 2.2±1.4, respectively). The incidence of treatment failure and the rate of glaucoma reoperation were significantly higher in the Baerveldt group (40%) compared to the Ahmed group (17%). Conclusion: Ahmed drainage implantation seemed to outclass that using the Baerveldt device in our study, in terms of efficacy and success rate.
The Impact of Glaucoma Drainage Devices on the Cornea
Current Ophthalmology Reports, 2020
Purpose of Review To discuss the relevant clinical associations between glaucoma drainage device (GDD) implantation and health of the cornea, focusing on corneal endothelial disease and success of viability of keratoplasty. Recent Findings Corneal endothelial injury and risk of graft failure continues to demonstrate association with GDD placement; however, newer studies demonstrate improved outcomes associated with Descemet membrane endothelial keratoplasty. Additionally, newer adverse effects associated with GDD placement have been described. Summary GDD implantation certainly carries risk of endothelial injury and keratoplasty viability, but newer keratoplasty techniques may improve visual outcomes. Furthermore, attention to placement and location of the GDD may affect the risk of progressive corneal injury.
In Vivo Testing of a Novel Adjustable Glaucoma Drainage Device
Investigative Ophthalmology & Visual Science, 2014
PURPOSE. We report on the in vivo testing of a novel noninvasively adjustable glaucoma drainage device (AGDD), which features an adjustable outflow resistance, and assess the safety and efficiency of this implant.
Saudi Journal of Ophthalmology, 2020
IntroductIon T he implantation of glaucoma drainage devices (GDD) has steadily increased over the last several years especially in eyes with failed filtration surgery. [1-5] GDD implantation has also been performed as a primary intervention in cases with a high risk for failed trabeculectomy. [1-5] The tube versus trabeculectomy (TVT) study, has reported higher success rates with GDD than trabeculectomy. [1] A recent prospective comparison of the Ahmed valve to the Baerveldt implant reported good success with minor differences between the implants. [6] However, most studies of these GDD report a risk of corneal decompensation that ranges from 10-16%, which is much higher than that reported after conventional trabeculectomy. [1,7-9] The higher rate of corneal decompensation after GDD implantation has been attributed to a number of factors including, the decreased distance between the tube tip and endothelium and mechanical touch during eye rubbing or eye movement and blinking. [10,11] An increased risk of corneal decompensation has also been correlated to the length of the tube. However, a recent study used multivariate analysis to report that only the distance between the tube tip and endothelium was significantly associated with postoperative endothelial cell loss and tube length was not a factor. [2] Pars plana insertion of the tube has
Advances in the Surgical Management of Glaucoma—The Role of the EX-PRESS® Glaucoma Filtration Device
US Ophthalmic Review, 2012
By reducing intraocular pressure (IOP), we aim to arrest the glaucomatous process. Our strategies include medical, laser, and surgical techniques. Trabeculectomy is the gold standard drainage surgery to achieve this; as there can be a high degree of variability in the procedure and its success depends on bleb creation, with the challenges of wound healing modulation, results remain unpredictable. Several devices are being assessed to try to achieve ‘minimally invasive glaucoma surgery’. While results will take some years to evaluate rigorously, it seems IOP levels by these means lie in the mid-teens. These minimally invasive glaucoma surgery techniques therefore would appear to be destined for patients whose glaucomatous damage is relatively mild to moderate and whose target IOPs fall into this range. To simultaneously achieve lower IOPs for patients with more advanced visual loss, efforts have been made to ‘fine-tune’ trabeculectomy. Use of the EX-PRESS® Glaucoma Filtration Device ...
Artificial drainage devices for glaucoma surgery: an overview
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH
Artificial drainage devices (ADD) create an alternative pathway for aqueous drainage from the anterior chamber of an eye through a tube to the subconjunctival bleb connected to an equatorial plate under the conjunctiva. The ADDs, both valved and non-valved, are available for end stage or refractory glaucoma. Currently, some of these devices, particularly the Express shunt, are recommended for the primary treatment of glaucoma. In this article, we highlight various ADDs, their indications and contraindications, surgical techniques and associated complications.