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D Spiegel, K Kobuch; Trabecular Meshwork Bypass Tube Shunt . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1069.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate a prospective consecutive case series of the inital 6 eyes of 5 patients undergoing implantation of the trabecular bypass tube shunt (TBTS). Methods: 6 eyes of 5 patients with uncontrolled open-angle glaucoma that had never previously undergone ocular surgery underwent implantation of the TBTS. This implantation of TBTS measuring 150 µm outer diameter and 50 µm inner diameter was performed with the distal end placed in Schlemm's canal and the proximal end in the anterior chamber. The main outcome measures were visual acuity, intraocular pressure, glaucoma medication use. Results: The tube was successfully implanted in 5 of 6 eyes. In 4 eyes longer-term follow-up of 5-9 months showed no loss of visual acuity with decreased intraocular pressure from preoperative levels (mean 23.4 to 16.5 mmHg) and reduced requirement of glaucoma medications (mean 3 to 0.5) and stable vision. In a subset of 2 eyes, there was no measured increase in aqueous flare or reduction of endothelial cell count. Conclusion: This study reports the initial experience with a novel approach to surgical glaucoma therapy. This very small tube allows a direct communication to be established between the anterior chamber and Schlemm's canal, effecting a trabecular bypass. In this small number of eyes this procedure reduced intraocular pressure and the need for glaucoma medications without appreciable side effects.
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