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Improvement of the loss of corneal endothelial cells by relocating the tip of the Baerveldt® implant tube from the anterior chamber to the vitreous cavity

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Abstract

Purpose

It has been reported that corneal endothelial cells (CEC) decrease faster when the tip of the Baerveldt glaucoma implant (BGI) tube is inserted into the anterior chamber than into the vitreous cavity. We investigated whether surgically relocating the tip of the BGI tube from the anterior chamber to the vitreous cavity could reduce CEC loss.

Patients and methods

This was a single facility retrospective cohort study. The inclusion criteria were the CEC density less than 1500 cells/mm2 and the CEC reduction ratio was greater than 10%/year. The subjects were 11 consecutive patients that could be followed > 12 months after relocation surgery. All patients were undergone vitrectomy, and the tip of tube was inserted into the vitreous cavity from the anterior chamber. We compared the intraocular pressure (IOP), reduction slope of CEC density and annual reduction rate of CEC density before and after relocation surgery. We calculated the annual reduction ratio in comparison with the preoperative CEC density (%/year).

Results

The mean of period between the Baeveldt with anterior chamber insertion surgery and the relocation surgery was 33.8 ± 15.0 months. The mean of follow-up after relocation surgery was 21.8 ± 9.8 months. The relocation surgery did not significantly change IOP (p = 0.974). The mean preoperative and postoperative IOP were 13.1 ± 4.5 and 13.6 ± 4.3 mmHg. The reduction ratio of the CEC density was 15.4 ± 6.7 (%/year) before relocation surgery and significantly slower at 8.3 ± 6.5 (%/year) after relocation surgery (p = 0.024). Two patients resulted in bullous keratopathy after relocation surgery.

Conclusions

Relocating the tip of BGI tube from the anterior chamber to the vitreous cavity could reduce CEC loss.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan

    Yuuki Honda, Akio Miyakoshi, Naoki Tojo & Atsushi Hayashi

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  1. Yuuki Honda
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  2. Akio Miyakoshi
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  3. Naoki Tojo
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  4. Atsushi Hayashi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Akio Miyakoshi, Yuuki Honda and Naoki Tojo. The first draft of the manuscript was written by Yuuki Honda and Naoki Tojo and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Naoki Tojo.

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The authors have no relevant financial or non-financial interests to disclose.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Toyama University.

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Honda, Y., Miyakoshi, A., Tojo, N. et al. Improvement of the loss of corneal endothelial cells by relocating the tip of the Baerveldt® implant tube from the anterior chamber to the vitreous cavity. Int Ophthalmol 43, 2795–2801 (2023). https://doi.org/10.1007/s10792-023-02677-3

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  • DOI: https://doi.org/10.1007/s10792-023-02677-3

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