One-year Outcomes Following Internal Ligation Suture Removal in 350 Mm Baerveldt Tube Implant Surgery

Overview

Journal J Curr Glaucoma Pract

Date 2022 Sep 5

PMID 36060047

Authors

Francesco Stringa

Ruth Chen

Pavi Agrawal

Affiliations

Soon will be listed here.

Abstract

Aim: Long-term data of the postoperative management following Baerveldt tube surgery (BVT) is currently limited. This study aims to evaluate the outcome and the safety profile of internal ligation suture removal after BVT surgery for refractory glaucoma.

Materials And Methods: A prospective, consecutive, non-comparative case series of patients previously undergoing BVT 350 mm surgery with 0.4 mg/mL mitomycin C (MMC), 3/0 intraluminal suture (Supramid) insertion, and 10/0 nylon external ligation suture(s). For each patient, data was collected over 12 months after internal ligation suture removal. Follow-up assessments looked at intraocular pressure (IOP), complication rate, and postoperative number of glaucoma medications. Definition of success was adopted as per the World Glaucoma Association recommendations.

Results: Twenty-four patients were included. On average, Supramid was removed at 22 ± 18.2 weeks following BVT surgery. Preoperatively, the mean IOP was 30.9 ± 12.6 mm Hg and the average antiglaucoma medications were 1.95 ± 1.13. At 12 months, the mean IOP was 15.2 ± 5.3 mm Hg and the mean number of glaucoma medications was 1.3 ± 0.2. Qualified success with IOP ≤ 21 mm Hg and IOP ≤ 15 mm Hg was achieved in 62.5% and 33.3%, respectively. Only two patients developed hypotony following Supramid removal; both resolved spontaneously within 1 month.

Conclusion: Our results show a good IOP reduction and safety profile at 1 year from internal ligation suture removal following BVT. A drop in IOP of approximately 50% from the preoperative IOP can be expected.

How To Cite This Article: Stringa F, Chen R, Agrawal P. One-year Outcomes Following Internal Ligation Suture Removal in 350 mm Baerveldt Tube Implant Surgery. J Curr Glaucoma Pract 2022;16(1):20-23.

References

Lloyd M, Baerveldt G, Heuer D, Minckler D, Martone J . Initial clinical experience with the baerveldt implant in complicated glaucomas. Ophthalmology. 1994; 101(4):640-50. DOI: 10.1016/s0161-6420(94)31283-8. View

SHERWOOD M, Smith M . Prevention of early hypotony associated with Molteno implants by a new occluding stent technique. Ophthalmology. 1993; 100(1):85-90. DOI: 10.1016/s0161-6420(93)31688-x. View

Gedde S, Chen P, Heuer D, Singh K, Wright M, Feuer W . The Primary Tube Versus Trabeculectomy Study: Methodology of a Multicenter Randomized Clinical Trial Comparing Tube Shunt Surgery and Trabeculectomy with Mitomycin C. Ophthalmology. 2017; 125(5):774-781. PMC: 9289720. DOI: 10.1016/j.ophtha.2017.10.037. View

Desai M, Gedde S, Feuer W, Shi W, Chen P, Parrish 2nd R . Practice preferences for glaucoma surgery: a survey of the American Glaucoma Society in 2008. Ophthalmic Surg Lasers Imaging. 2011; 42(3):202-8. DOI: 10.3928/15428877-20110224-04. View

Gedde S, Schiffman J, Feuer W, Herndon L, Brandt J, Budenz D . Three-year follow-up of the tube versus trabeculectomy study. Am J Ophthalmol. 2009; 148(5):670-84. DOI: 10.1016/j.ajo.2009.06.018. View

HaiBo T, Xin K, ShiHeng L, Lin L . Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis. PLoS One. 2015; 10(2):e0118142. PMC: 4342169. DOI: 10.1371/journal.pone.0118142. View

Lee R, Bouremel Y, Eames I, Brocchini S, Khaw P . A Case Report of Complete Blockage of a Baerveldt Glaucoma Implant Following Insertion of a 3-0 Supramid Suture. J Glaucoma. 2019; 28(5):e75-e76. DOI: 10.1097/IJG.0000000000001198. View

Budenz D, Barton K, Gedde S, Feuer W, Schiffman J, Costa V . Five-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology. 2014; 122(2):308-16. PMC: 4306613. DOI: 10.1016/j.ophtha.2014.08.043. View

Nguyen Q, Budenz D, Parrish 2nd R . Complications of Baerveldt glaucoma drainage implants. Arch Ophthalmol. 1998; 116(5):571-5. DOI: 10.1001/archopht.116.5.571. View

10.

Christakis P, Kalenak J, Tsai J, Zurakowski D, Kammer J, Harasymowycz P . The Ahmed Versus Baerveldt Study: Five-Year Treatment Outcomes. Ophthalmology. 2016; 123(10):2093-102. DOI: 10.1016/j.ophtha.2016.06.035. View

11.

Breckenridge R, Bartholomew L, Crosson C, Kent A . Outflow resistance of the Baerveldt glaucoma drainage implant and modifications for early postoperative intraocular pressure control. J Glaucoma. 2004; 13(5):396-9. DOI: 10.1097/01.ijg.0000131759.48295.5c. View

12.

Kansal S, Moster M, Kim D, Schmidt Jr C, Wilson R, Katz L . Effectiveness of nonocclusive ligature and fenestration used in Baerveldt aqueous shunts for early postoperative intraocular pressure control. J Glaucoma. 2002; 11(1):65-70. DOI: 10.1097/00061198-200202000-00012. View

13.

Trible J, Brown D . Occlusive ligature and standardized fenestration of a Baerveldt tube with and without antimetabolites for early postoperative intraocular pressure control. Ophthalmology. 1998; 105(12):2243-50. DOI: 10.1016/S0161-6420(98)91223-4. View