To assess the safety and effectiveness of the SOLX gold shunt (GS) in reducing intraocular pressure (IOP) in Japanese patients with open angle glaucoma (OAG).
24 eyes of 24 subjects [mean age of 68.9 ± 12.7 years; 13 (54%) women; 16 (67%) POAG, 7 (29%) pseudoexfoliation glaucoma, and 1 (4%) steroid response glaucoma] were implanted with the GS either with or without cataract surgery. Best-corrected visual acuity (BCVA), IOP, corneal endothelial cell density (CECD), anterior chamber (AC) flare, surgical complications, and required interventions were monitored at baseline, and 1 day, 1 week, 1, 3 and 6 months, and 1 year postoperatively.
Baseline IOP of 21.3 ± 4.1 mmHg and glaucoma medications of 3.5 ± 1.0 were significantly reduced at every follow-up visit. At 1 year postoperatively, IOP was 16.4 ± 5.8 mmHg (23% reduction from baseline, p < 0.0001) with use of 2.1 ± 1.1 medications (40% reduction from baseline, p = 0.0002). Intraoperative hyphema occurred in 5 (21%) eyes. Transient bleb formation occurred in 20 (83%) eyes, and AC cell was reported in 17 (71%) eyes. Inflammation-related complications such as posterior and anterior synechiae, or iritis/keratic precipitates tended to occur during late postoperative periods. At 1 year, BCVA was unchanged or improved in 23 (96%) eyes. AC flare was elevated at 1 week postoperatively and later. CECD declined at 3 months and 1 year postoperatively.
The GS is effective in reducing IOP in Japanese patients with OAG. Chronic inflammation in AC might be associated with late onset complications.
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Collaborative normal-tension glaucoma study group. Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Am J Ophthalmol. 1998;126:487–97.
The AGIS investigators. The advanced glaucoma intervention study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 2000;130:429–40.
Garway-Heath DF, Crabb DP, Bunce C, Lascaratos G, Amarfitano F, Anand N, et al. Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trial. Lancet. 2015;385:1295–304.
Gigon A, Shaarawy T. The suprachoroidal route in glaucoma surgery. J Curr Glaucoma Pract. 2016;10:13–20.
Melamed S, Ben Simon GJ, Goldenfeld M, Simon G. Efficacy and safety of gold micro shunt implantation to the supraciliary space in patients with glaucoma: a pilot study. Arch Ophthalmol. 2009;127(3):264–9.
Hoeh H, Ahmed II, Grisanti S, Grisanti S, Grabner G, Nguyen QH, et al. Early postoperative safety and surgical outcomes after implantation of a suprachoroidal micro-stent for the treatment of open-angle glaucoma concomitant with cataract surgery. J Cataract Refract Surg. 2013;39:431–7.
Hoeh H, Vold SD, Ahmed IK, Anton A, Rau M, Singh K, et al. Initial clinical experience with the cypass micro-stent: safety and surgical outcomes of a novel supraciliary microstent. J Glaucoma. 2016;25:106–12.
Oatts JT, Zhang Z, Tseng H, Shields MB, Sinard JH, Loewen NA. In vitro and in vivo comparison of two suprachoroidal shunts. Invest Ophthalmol Vis Sci. 2013;54:5416–23.
Cseke I, Vamosi P, Bausz M. Starflo glaucoma implant: early experience in Hungary. Rom J Ophthalmol. 2016;60:14–7.
Emi K, Pederson JE, Toris CB. Hydrostatic pressure of the suprachoroidal space. Invest Ophthalmol Vis Sci. 1989;30:233–8.
Figus M, Lazzeri S, Fogagnolo P, Iester M, Martinelli P, Nardi M. Supraciliary shunt in refractory glaucoma. Br J Ophthalmol. 2011;95:1537–41.
Mastropasqua L, Agnifili L, Ciancaglini M, Nubile M, Carpineto P, Fasanella V, et al. In vivo analysis of conjunctiva in gold micro shunt implantation for glaucoma. Br J Ophthalmol. 2010;94:1592–6.
Hueber A, Roters S, Jordan JF, Konen W. Retrospective analysis of the success and safety of gold micro shunt implantation in glaucoma. BMC Ophthalmol. 2013;13:35.
Skaat A, Sagiv O, Kinori M, Ben Simon GJ, Goldenfeld M, Melamed S. Gold micro-shunt implants versus ahmed glaucoma valve: long-term outcomes of a prospective randomized clinical trial. J Glaucoma. 2016;25:155–61.
Tanito M, Ohira A, Chihara E. Surgical outcome of combined trabeculotomy and cataract surgery. J Glaucoma. 2001;10:302–8.
Tanito M, Park M, Nishikawa M, Ohira A, Chihara E. Comparison of surgical outcomes of combined viscocanalostomy and cataract surgery with combined trabeculotomy and cataract surgery. Am J Ophthalmol. 2002;134:513–20.
Chihara E, Hayashi K. Effect of a fenestration between an intrascleral lake and supraciliary space on deep sclerectomy. J Glaucoma. 2016;25:e299–307.
Lee RY, Huang G, Porco TC, Chen YC, He M, Lin SC. Differences in iris thickness among African Americans, Caucasian Americans, Hispanic Americans, Chinese Americans, and Filipino-Americans. J Glaucoma. 2013;22:673–8.
Oh YG, Minelli S, Spaeth GL, Steinman WC. The anterior chamber angle is different in different racial groups: a gonioscopic study. Eye. 1994;8:104–8.
Agnifili L, Costagliola C, Figus M, Iezzi G, Piattelli A, Carpineto P, et al. Histological findings of failed gold micro shunts in primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol. 2012;250:143–9.
Berk TA, Tam DY, Werner L, Mamalis N, Ahmen II. Electron microscopic evaluation of a gold glaucoma micro shunt after explantation. J Cataract Refract Surg. 2015;41:674–80.
Rekas M, Pawlik B, Grala B, Kozlowski W. Clinical and morphological evaluation of gold micro shunt after unsuccessful surgical treatment of patients with primary open-angle glaucoma. Eye. 2013;27:1214–7.
Conflicts of interest
M. Tanito, Supply of shunts (SOLX), Lecture fees (Aeon Astron, Alcon, HOYA, JFC, Kowa, MSD, NIDEK, Otsuka, Pfizer, Santen, Senju); E. Chihara, Supply of shunts (SOLX), Lecture fees (Alcon, Chuo Sangio, Kowa, Pfizer, Santen, Senjyu).
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Tanito, M., Chihara, E. Safety and effectiveness of gold glaucoma micro shunt for reducing intraocular pressure in Japanese patients with open angle glaucoma. Jpn J Ophthalmol 61, 388–394 (2017). https://doi.org/10.1007/s10384-017-0520-2
- SOLX gold-shunt
- Open angle glaucoma
- Glaucoma surgery
- Intraocular pressure
- Anterior chamber flare