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 Two days later, since medical therapy was ineffective, the tube was withdrawn from the anterior chamber and irrigated with a polyvinyl alcohol-iodine solution, and the tube was tucked into the subconjunctival space.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.

Double versus single suture stenting to manage hypertensive spikes after glaucoma drainage device implantation

2021 ◽  
pp. 112067212110143
Author(s):  
Francesca Chemello ◽  
Anna Rodella ◽  
Guido Barosco ◽  
Piero Ceruti ◽  
Roberto Tosi ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Early Postoperative Period ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Device Implantation ◽  
Baerveldt Glaucoma Implant ◽  
The Mean ◽  
Group 2 ◽  
Single Suture ◽  
Group 1

Purpose: To evaluate the safety and efficacy of double compared to single intraluminal suture stenting in reducing early postoperative hypertensive spikes (HS) and hypotony after Baerveldt glaucoma implant surgery. Methods: For this retrospective study, we reviewed the medical charts of 60 patients (60 eyes) who underwent Baerveldt drainage device surgery between 2017 and 2019. Two groups were formed according to whether a single suture stent was placed within the tube (5-0 polypropylene, 30 eyes, group 1) or a double suture (5-0 and 6-0 polypropylene, 30 eyes, group 2). Intraocular pressure (IOP) was measured at baseline, at 6 h, and on postoperative days 1, 2, 5, 7, 14, 21, 30, 60, 90, 180. The occurrence of HS (IOP ⩾ 30 mmHg), anterior chamber reformation, decompressive paracentesis, anti-glaucoma medication, and adverse events were recorded. Results: There was a greater decrease in IOP from baseline at days 1, 2, and 21 ( p < 0.05) and number of HS at 6 h ( p = 0.006) and postoperative day 1 ( p < 0.001) in group 2. The mean number of decompressive paracentesis, anterior chamber reformation procedures, and topical anti-glaucoma medications was the same in both groups; the need for oral acetazolamide was significantly lower in group 2 at days 1, 21, and 30 ( p < 0.05). Conclusions: While both stenting methods provide a gradual, controlled decrease in IOP, the double stenting technique was associated with a sooner and greater postoperative reduction in IOP and a good safety profile thanks to fewer HS in the early postoperative period and less need for oral acetazolamide.

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.

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

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.

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.

scholarly journals Outcome of a Low-Cost Glaucoma Implant versus the Baerveldt Glaucoma Implant for Paediatric Glaucoma in a Tertiary Hospital in Egypt

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Mahmoud F. Rateb ◽  
Hazem Abdel Motaal ◽  
Mohamed Shehata ◽  
Mohamed Anwar ◽  
Dalia Tohamy ◽  
...  
Keyword(s):  
Low Cost ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Group A ◽  
Baerveldt Glaucoma Implant ◽  
The Mean ◽  
Group B

Purpose. To compare safety and efficacy between a low-cost glaucoma drainage device (GDD), the Aurolab aqueous drainage implant (AADI), and the Baerveldt glaucoma implant (BGI) in refractory childhood glaucoma in Egypt. Methods. This is a retrospective study of patients who received either an AADI or BGI at a tertiary care postgraduate teaching institute. Children aged <16 years with uncontrolled intraocular pressure (IOP) with or without prior failed trabeculectomy who completed a minimum 6-month follow-up were included. The outcome measures were IOP reduction from preoperative values and postoperative complications. Results. Charts of 57 children (younger than 16 years old) diagnosed with refractory childhood glaucoma were included. Of these, 27 eyes received AADI implants (group A), while 30 received BGI implants (group B). The mean preoperative baseline IOP was 34 ± 5 mmHg in group A versus 29 ± 2 mmHg in group B (p=0.78) in patients on maximum allowed glaucoma medications. In group A versus group B, the mean IOP decreased to 13.25 ± 8.74 mmHg (p=0.6), 12.8 ± 5.4 mmHg (p=0.7), and 12.6 ± 5.6 mmHg (p=0.9) after 1 week, 3 months, and 6 months, respectively. However, in group A, an anterior chamber reaction appeared around the tube in 14 cases starting from the first month and resolved with treatment in only 4 cases. In the other 10 cases, the reaction became more severe and required surgical intervention. This complication was not observed in any eye in group B. Conclusion. AADI, a low-cost glaucoma implant, is effective in lowering IOP in patients with recalcitrant paediatric glaucoma. However, an intense inflammatory reaction with serious consequences developed in some of our patients; we believe these events are related to the valve material. We therefore strongly recommend against its use in children.

Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) Outcomes in High-Risk Patients

2021 ◽  
Author(s):  
Blanca Elizabeth Martínez-Báez ◽  
Abraham Alejandro Medina-Andrade ◽  
Gonzalo García de Oteyza ◽  
Everardo Hernández Quintela ◽  
Ana Mercedes Garcia-Albisua ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Risk ◽  
Anterior Chamber ◽  
Graft Failure ◽  
Glaucoma Drainage Device ◽  
Endothelial Keratoplasty ◽  
Corneal Surgery ◽  
High Risk Patients ◽  
Drainage Device ◽  
Risk Patients

Abstract Purpose To evaluate the results, survival rates, and proportion of complications related to Descemet Stripping Automated Endothelial Keratoplasty in high-risk patients. Methods Thirty-three patients (thirty-four eyes) who underwent DSAEK surgery between 2015 and 2019 were included in this retrospective, observational study. All participants were considered high-risk patients with a history of previous glaucoma surgery with glaucoma drainage device, previous graft failure, previous anterior chamber intraocular lens, or glaucoma with an indication of corneal surgery. Results After 7.1 months of follow-up (range from 1 to 35.9 months), seventeen eyes (50%) had graft failure. Among those, eight eyes (47%) belonged to the previous graft failure group, and seven eyes (41%) had a glaucoma drainage device in the anterior chamber. Although best-corrected visual acuity (BCVA) did not improve significantly postoperatively (p = 0.112), twelve eyes improved their visual acuity, and fifteen eyes remained unchanged. The percentage of eyes with BCVA of 20/40 or better improved from 11% preoperatively to 26% postoperatively. The most common surgical complication was lamellae dislocation, occurring in six eyes. Conclusions Adverse outcomes are highly common in high-risk patients who receive a DSAEK, especially in those patients for whom a graft previously failed or with a glaucoma drainage device. The most common complication was graft detachment, with a rate similar to other reports in non-high-risk patients. In our series, previous graft failure is a higher risk factor than a GDD.

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