SURGICAL TECHNIQUE FOR THE PLACEMENT OF AN ENCIRCLING SCLERAL BUCKLE IN THE PRESENCE OF A GLAUCOMA DRAINAGE DEVICE

Background: Step by step surgical technique for closure of dehisced conjunctiva in a patient with glaucoma drainage device (GDD). Purpose: To describe a step by step new surgical technique using combined tutoplast, conjunctival autograft and amniotic membrane to close dehisced conjunctiva in a patient with GDD. Case report: Patient with previous history of herpetic kerato uveitis and Baerveldt tube developed dehiscence of conjunctiva over the plate. He had previous surgical interventions on two occasions, which consisted of direct closure of the conjunctiva and conjunctival autograft, with no success. In order to close the persistent defect, he underwent additional surgery in the form of relieving conjunctival incisions, tutoplast, conjunctival autograft and amniotic membrane to ensure closure of defect and healing. Conclusions: Tube/plate erosions are a very challenging problem to manage, especially in eyes that have undergone several surgical interventions. As demonstrated here, tutoplast, conjunctival autograft and amniotic membrane can be used in conjunction, in situations where conjunctival scarring otherwise preclude successful repair.

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Surgical technique, perioperative management and early outcome data of the PAUL® glaucoma drainage device

Eye ◽

10.1038/s41433-021-01737-1 ◽

2021 ◽

Author(s):

Neeru Amrita Vallabh ◽

Fiona Mason ◽

Jonathan T. S. Yu ◽

Kenneth Yau ◽

Cecilia H. Fenerty ◽

...

Keyword(s):

Surgical Technique ◽

Perioperative Management ◽

Outcome Data ◽

Glaucoma Drainage Device ◽

Early Outcome ◽

Drainage Device

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Faculty Opinions recommendation of Early aqueous suppressant therapy on hypertensive phase following glaucoma drainage device procedure: A randomized prospective trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718892715.793507038 ◽

2015 ◽

Author(s):

Marcelo Nicolela

Keyword(s):

Prospective Trial ◽

Glaucoma Drainage Device ◽

Drainage Device ◽

Randomized Prospective Trial ◽

Hypertensive Phase

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Glaucoma drainage device surgery for refractory childhood glaucoma—safely managing the short eye

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/j.jaapos.2019.08.139 ◽

2019 ◽

Vol 23 (4) ◽

pp. e39

Author(s):

HongVan T. Le ◽

Ann Shue ◽

Sharon Freedman

Keyword(s):

Glaucoma Drainage Device ◽

Drainage Device

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Severe Hypotony-induced Intraocular Inflammation after Removal of Ripcord Suture from a Glaucoma Drainage Device in Uveitis Patient

Ocular Immunology and Inflammation ◽

10.1080/09273948.2021.1903936 ◽

2021 ◽

pp. 1-3

Author(s):

Ilaria Testi ◽

Peter Addison ◽

Winifred Nolan ◽

Carlos Pavesio

Keyword(s):

Intraocular Inflammation ◽

Glaucoma Drainage Device ◽

Drainage Device

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Combined pars plana glaucoma drainage device placement and vitrectomy using a vitrectomy sclerotomy site for tube placement: a case series

BMC Ophthalmology ◽

10.1186/s12886-021-01872-z ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Enchi Kristina Chang ◽

Sanchay Gupta ◽

Marika Chachanidze ◽

John B. Miller ◽

Ta Chen Chang ◽

...

Keyword(s):

Visual Acuity ◽

Pars Plana Vitrectomy ◽

Case Series ◽

Tube Placement ◽

Glaucoma Drainage Device ◽

Drainage Device ◽

Glaucoma Drainage Devices ◽

Pars Plana ◽

Sclerotomy Site

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

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