scholarly journals Short-Term Outcomes of KeraSys Patch Graft for Glaucoma Drainage Devices: A Case Series

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Kundandeep S. Nagi ◽  
Ricardo J. Cumba ◽  
Nicholas P. Bell ◽  
Lauren S. Blieden ◽  
Alice Z. Chuang ◽  
...  
Keyword(s):  
Case Series ◽  
Wound Dehiscence ◽  
Glaucoma Drainage Device ◽  
Exposure Rate ◽  
Early Exposure ◽  
Consecutive Case ◽  
Short Term ◽  
Drainage Device ◽  
Glaucoma Drainage Devices ◽  
Patch Graft

Purpose. Tube-related exposure is a known complication of glaucoma drainage device (GDD) surgery. Our objective is to report the early (approximately 1 year) tube exposure rate of implants covered with a keraSys (IOP Inc., Costa Mesa, CA, USA) tissue reinforcement graft.Patients and Methods. A retrospective, noncomparative, consecutive case series of 42 eyes with GDD implantation with keraSys patch grafts was performed. Main outcome measurements included patch-related complications: patch exposure, tube exposure, wound dehiscence, and patch migration.Results. Forty-two eyes were followed for an average of15.24±10.44months (range 1.0–32.3 months). Four (10%) eyes experienced patch-related complications: two with exposure 8 months postoperatively, one with exposure 13 months postoperatively, and one with exposure 4 weeks postoperatively.Conclusion. The effectiveness of the keraSys patch graft is limited by the higher than expected early exposure rate found in this case series. These results should be confirmed in other studies.

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

2021 ◽  
Vol 21 (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.

scholarly journals Combined Scleral Flap with Donor Scleral Patch Graft for Anterior Tube Placement in Glaucoma Drainage Device Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Jea H. Yu ◽  
Chuck Nguyen ◽  
Esmeralda Gallemore ◽  
Ron P. Gallemore
Keyword(s):  
Open Angle Glaucoma ◽  
Effective Means ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Scleral Flap ◽  
Retrospective Case ◽  
Glaucoma Drainage Devices ◽  
Patch Graft

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. Two had neovascular glaucoma and one had primary open-angle glaucoma (POAG). On average, intraocular pressure was reduced from39±14 mmHg to15±2 mmHg and the number of glaucoma medications was reduced from4±1to 0. Preoperative and most recent visual acuities were hand-motion (HM) and HM, 20/60 and 20/50, and 20/70 and 20/30, respectively.Conclusion. The combination of a limbal-based scleral flap with scleral patch graft to cover the tube with glaucoma drainage devices may be an effective means to reduce erosion and protect against endophthalmitis.

Comparison of Single Thickness and Double Thickness Processed Pericardium Patch Graft in Glaucoma Drainage Device Surgery

2008 ◽  
Vol 17 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Dara Lankaranian ◽  
Ricardo Reis ◽  
Jeffrey D. Henderer ◽  
Sung Choe ◽  
Marlene R. Moster
Keyword(s):  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Patch Graft

Heterologous, Human Donor Sclera as the Patch Graft in Glaucoma Drainage Device Surgery

2017 ◽  
Vol 26 (3) ◽  
pp. e128-e129 ◽  
Author(s):  
Suneeta Dubey ◽  
Ketaki Rajurkar ◽  
Neha Kapur ◽  
Manisha Acharya
Keyword(s):  
Glaucoma Drainage Device ◽  
Human Donor ◽  
Drainage Device ◽  
Patch Graft

scholarly journals Baerveldt Scleral Patch Graft Abscess Secondary to Coagulase-Negative Staphylococcus

2017 ◽  
Vol 8 (3) ◽  
pp. 521-526
Author(s):  
Van Nguyen ◽  
Mason Schmutz ◽  
Sarah Farukhi ◽  
Sameh Mosaed
Keyword(s):  
Open Angle Glaucoma ◽  
Staphylococcal Infection ◽  
Glaucoma Drainage Device ◽  
Coagulase Negative Staphylococcus ◽  
Drainage Device ◽  
Implant Placement ◽  
First Case ◽  
Severe Stage ◽  
Device Placement ◽  
Patch Graft

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. Culture of the abscess revealed coagulase-negative Staphylococcus. As alluded to above, the patient also had multiple abscesses on the skin that cultured positive for Staphylococcus aureus. To our knowledge, this is the first case in the literature of coagulase-negative Staphylococcus causing an early postoperative abscess of the scleral patch graft following glaucoma drainage device placement.

Long-Term Persistence of Fascia Lata Patch Graft in Glaucoma Drainage Device Surgery

2005 ◽  
Vol 15 (3) ◽  
pp. 412-414 ◽  
Author(s):  
E. GutiéRrez-Díaz ◽  
M. Montero-Rodríguez ◽  
E. Mencía-Gutiérrez ◽  
A. Cabello ◽  
J. Monescillo
Keyword(s):  
Fascia Lata ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Patch Graft

scholarly journals Partial thickness corneal tissue as a patch graft material for prevention of glaucoma drainage device exposure

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Oriel Spierer ◽  
Michael Waisbourd ◽  
Yitzhak Golan ◽  
Hadas Newman ◽  
Rony Rachmiel
Keyword(s):  
Glaucoma Drainage Device ◽  
Corneal Tissue ◽  
Graft Material ◽  
Drainage Device ◽  
Partial Thickness ◽  
Patch Graft

Allogenic dehydrated human pericardium patch graft (Tutoplast): A novel use for reconstruction in orbital implant exposure

2021 ◽  
pp. 112067212110043
Author(s):  
Hetvi Bhatt ◽  
Linda Okafor ◽  
Rina Bhatt
Keyword(s):  
Case Series ◽  
Glaucoma Drainage Device ◽  
Fat Graft ◽  
Silicone Implants ◽  
Orbital Implant ◽  
Presenting Symptoms ◽  
Implant Exposure ◽  
Patch Graft ◽  
Human Pericardium

Purpose: Exposure of orbital implant post enucleation or evisceration remains one of the common complications irrespective of the type of implant used. Dermis fat graft and temporalis fascia have been used to repair the implant exposure in anophthalmic sockets. Tutoplast® pericardium, gamma sterilised dehydrated human pericardium, has been used as a scleral patch graft for glaucoma drainage device exposure and scleral thinning post squint surgery. We report the novel use of Tutoplast® patch graft to repair orbital implant exposure in this case series. Methods: The case notes of three patients who received Tutoplast® pericardium patch graft to repair implant exposure were reviewed. Data regarding presenting symptoms, implant type, time to exposure from primary surgery, post-operative complications and length of follow up post Tutoplast® pericardium patch graft were collected. Results: Three patients presented with implant exposure following evisceration. The presenting symptoms were recurrent infection, discharging socket and discomfort in all three patients. One patient had a Medpore implant, two had silicone implants. Total follow-up ranged from 9 to 22 months. In all three cases, there was relief from symptoms and the graft had incorporated fully into the surrounding orbital tissue with no recurrent exposure noted during the follow-up period. Conclusion: Tutoplast® pericardium has demonstrated a good safety profile and is a suitable material to use as a patch graft for orbital implant exposure.

scholarly journals Corynebacterium ocular infection after Baerveldt glaucoma implant surgery: treatment involving immediate tube withdrawal and temporary subconjunctival tube placement: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Naruka Mitsui ◽  
Kae Sugihara ◽  
Jiro Seguchi ◽  
Etsuo Chihara ◽  
Yuki Morizane ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Vitreous Body ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Ocular Infection ◽  
Implant Surgery ◽  
Drainage Device ◽  
Old Japanese ◽  
Patch Graft ◽  
Baerveldt Glaucoma Implant

Abstract Background We report a case of Corynebacterium endophthalmitis secondary to tube exposure following Baerveldt glaucoma implant surgery that was successfully treated with prompt tube withdrawal and temporary subconjunctival tube placement without removing the glaucoma drainage device. Case presentation A 65-year-old Japanese man with secondary glaucoma underwent glaucoma drainage device surgery with a donor scleral patch graft in the inferonasal quadrant of his right eye. Ten months after surgery, he presented with tube exposure due to dehiscence of the overlying conjunctiva and erosion of the scleral patch graft. Eleven days later, mild inflammation was found in the anterior chamber and anterior vitreous body, with the root of the tube surrounded by a plaque at the site of insertion in the anterior chamber. He was diagnosed with infectious endophthalmitis secondary to tube exposure. Two days later, since medical therapy was ineffective, the tube was withdrawn from the anterior chamber and irrigated with a polyvinyl alcohol-iodine solution, and the tube was tucked into the subconjunctival space. Complete resolution of the infection was achieved 1.5 months later. The tube was reinserted nasally into the anterior chamber and covered with a scleral patch graft and a free limbal conjunctival autograft. Thereafter, there has been no recurrence of infection or tube exposure. Twenty eight months after tube reinsertion, his right best-corrected visual acuity was 20/50 and intraocular pressure was 12 mmHg. Conclusion Prompt tube withdrawal and temporary subconjunctival tube placement followed by tube reinsertion may be effective for endophthalmitis associated with tube exposure after glaucoma drainage device surgery.

scholarly journals Predicting Failures of Molteno and Baerveldt Glaucoma Drainage Devices Using Machine Learning Models

2020 ◽  
Author(s):  
Paul Morrison ◽  
Maxwell Dixon ◽  
Arsham Sheybani ◽  
Bahareh Rahmani
Keyword(s):  
Machine Learning ◽  
Logistic Regression ◽  
Glaucoma Drainage Device ◽  
Recursive Feature Elimination ◽  
Support Vector ◽  
Learning Models ◽  
Demographic Information ◽  
Drainage Device ◽  
Glaucoma Drainage Devices ◽  
Machine Learning Models

The purpose of this retrospective study is to measure machine learning models' ability to predict glaucoma drainage device (GDD) failure based on demographic information and preoperative measurements. The medical records of sixty-two patients were used. Potential predictors included the patient's race, age, sex, preoperative intraocular pressure (IOP), preoperative visual acuity, number of IOP-lowering medications, and number and type of previous ophthalmic surgeries. Failure was defined as final IOP greater than 18 mm Hg, reduction in IOP less than 20% from baseline, or need for reoperation unrelated to normal implant maintenance. Five classifiers were compared: logistic regression, artificial neural network, random forest, decision tree, and support vector machine. Recursive feature elimination was used to shrink the number of predictors and grid search was used to choose hyperparameters. To prevent leakage, nested cross-validation was used throughout. Overall, the best classifier was logistic regression.

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