Abstract
Purpose
To report the early results of suprachoroidal silicone implant surgery in intractable glaucoma.
Materials and methods
A modified silicone implant with no valve was implanted into the suprachoroidal space of 15 eyes with intractable glaucoma.
Results
The mean age of the patients was 53.0 ± 24.5 (range 7–85) years, the mean follow-up time was 17.1 ± 4.8 (range 10–28) months, and the mean preoperative intraocular pressure (IOP) of patients receiving two or more medications was 33.1 ± 9.8 mmHg. At the last follow-up visit, mean IOP was 16.5 ± 7.9 (range 10–35) mmHg (Wilcoxon signed rank test, p = 0.001). The functional success, i.e., IOP ≤21 mmHg both with and without antiglaucomatous drugs, was 93.3%. The total success rate, i.e., IOP ≤21 mmHg without medication, was 13.3%. The average number of antiglaucomatous drugs used was 3.8 (range 2–5) preoperatively, and 2.2 postoperatively (range 0–4) (Wilcoxon signed rank test, p = 0.011). There was a ≥30% decrease in the IOP of 66.6% of the eyes. Shallow choroidal detachment as proof of drainage was evident in all cases.
Conclusion
Drainage of the aqueous humor from the anterior chamber to the suprachoroidal space via implantation of a modified silicone implant is effective in lowering the IOP in intractable glaucoma.
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References
Dietlein TS, Jordan J, Lueke C, Krieglstein GK. Modern concepts in antiglaucomatous implant surgery. Graefes Arch Clin Exp Ophthalmol. 2008;246:1653–64.
Fluorouracil Filtering Surgery Study Group. Fluorouracil Filtering Surgery Study one-year follow-up. Am J Ophthalmol. 1989;108:625–35.
Skuta GL, Beeson CC, Higginbotham EJ, Lichter PR, Musch DC, Bergstrom TJ, et al. Intraoperative mitomycin versus postoperative 5-fluorouracil in high risk glaucoma filtering surgery. Ophthalmology. 1992;99:438–44.
Classen L, Kivela T, Tarkkanen A. Histopathologic and immunohistochemical analysis of the filtration bleb after unsuccessful glaucoma seton implantation. Am J Ophthalmol. 1996;122:205–12.
Jordan JF, Engels BF, Dinslage S, Dietlein TS, Ayertey HD, Roters S, et al. A novel approach to suprachoroidal drainage for the surgical treatment of intractable glaucoma. J Glaucoma. 2006;15:200–5.
Bill A. Conventional and uveo-scleral drainage of aqueous humor in the cynomolgus monkey (Macaca irus) at normal and high intraocular pressures. Exp Eye Res. 1966;5:45–54.
Bill A, Phillips CI. Uveoscleral drainage of aqueous humor in human eyes. Exp Eye Res. 1971;12:275–81.
Toris CB, Yablonski ME, Wang YL, Camras CB. Aqueous humor dynamics in the aging human eye. Am J Ophthalmol. 1999;127:407–12.
Alm A, Villumsen J. PhXA34, a new potent ocular hypotensive drug. A study on dose response relationship and on aqueous humor dynamics in healthy volunteers. Arch Ophthalmol. 1991;109:1564–8.
Portney GL. Silicone elastomer implantation cyclodialysis. A negative report. Arch Ophthalmol. 1973;89:10–2.
Ozdamar A, Aras C, Karacorlu M. Suprachoroidal seton implantation in refractory glaucoma: a novel surgical technique. J Glaucoma. 2003;12:354–9.
Yablonski ME. Trabeculectomy with internal tube shunt: a novel glaucoma surgery. J Glaucoma. 2005;14:91–7.
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.
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Palamar, M., Ates, H., Oztas, Z. et al. Suprachoroidal implant surgery in intractable glaucoma. Jpn J Ophthalmol 55, 351–355 (2011). https://doi.org/10.1007/s10384-011-0035-1
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DOI: https://doi.org/10.1007/s10384-011-0035-1