Faculty Collaboration Database

Aqueous tube shunt to a preexisting episcleral encircling element in the treatment of complicated glaucomas. Ophthalmology 1994 Jun;101(6):1036-43

Date

06/01/1994

Pubmed ID

8008344

DOI

10.1016/s0161-6420(94)31221-8

Scopus ID

2-s2.0-0028334429 (requires institutional sign-in at Scopus site)   39 Citations

Abstract

PURPOSE: The treatment of glaucoma after scleral buckling surgery is often problematic. The authors investigated a series of patients in whom a silicone tube was implanted to shunt aqueous from the anterior segment to the fibrous capsule surrounding a previously placed silicone episcleral encircling element.

METHODS: Thirteen patients were retrospectively reviewed. In each patient, a silicone tube was inserted through a small incision into the fibrous capsule overlying the scleral explant. In most patients, no attempt was made to secure the distal end of the tube to the silicone band. The proximal end of the tube was inserted into the eye via a needle track.

RESULTS: Successful control of intraocular pressure (IOP) (6 mm Hg < or = final IOP or < 21 mmHg with or without medication) was ultimately achieved in 11 (85%) of 13 patients (3 of the successful patients underwent one or more surgical revisions to relieve obstruction of the proximal and/or distal tube opening). Follow-up in these patients ranged from 8 to 49 months (mean +/- standard deviation, 21.7 +/- 14.1 months). The final postoperative visual acuities were within one line of the preoperative visual acuities or had improved in 11 (85%) patients. Complications included serous choroidal detachment (3 patients; 23%), conjunctival wound leak (2 patients; 15%), hyphema (1 patient; 8%), and tube obstruction by lens, iris, vitreous, or episcleral fibrous tissue (4 patients; 31%).

CONCLUSION: Aqueous tube shunt to a pre-existing episcleral encircling element is useful in treating complicated glaucomas after scleral buckling surgery. Fibrous obstruction of the external tube opening is a frequent complication in the early postoperative period, but it may be relieved by surgical revision.

Author List

Sidoti PA, Minckler DS, Baerveldt G, Lee PP, Heuer DK

Author

Dale Heuer MD Emeritus Professor in the Ophthalmology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Anterior Eye Segment
Aqueous Humor
Drainage
Follow-Up Studies
Glaucoma
Humans
Intraocular Pressure
Middle Aged
Postoperative Complications
Prostheses and Implants
Reoperation
Retinal Detachment
Sclera
Scleral Buckling
Silicone Elastomers
Visual Acuity