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Safety and effectiveness of gold glaucoma micro shunt for reducing intraocular pressure in Japanese patients with open angle glaucoma

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Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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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Author information

Correspondence to Masaki Tanito.

Ethics declarations

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).

Electronic supplementary material

Below is the link to the electronic supplementary material.

Video 1 Surgical video. The SOLX Gold Shunt is implanted at inferior-nasal quadrant (right eye) (MOV 14893 kb)

Video 1 Surgical video. The SOLX Gold Shunt is implanted at inferior-nasal quadrant (right eye) (MOV 14893 kb)

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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

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Keywords

  • SOLX gold-shunt
  • Open angle glaucoma
  • Glaucoma surgery
  • Intraocular pressure
  • Anterior chamber flare