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Susana Duch, Oana Stirbu, Elena Milla, Oscar Buchacra Castellano; Persistent hypotony associated to the use of immunosuppressive therapy in glaucoma drainage implants. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4791. doi: https://doi.org/.
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To describe the histopathology of non-valved implants in three cases of persistent postoperative Hypotony after the restrictive tube ligature was released, in patients under long term immunosuppressive therapy.
Human tissue study of surgical pathology specimens with clinicopathological correlation
The macroscopic appearance of the capsules, 3 and 4 months postoperatively, was immature and loose. Microscopic examination disclosed extremely irregular and loose tissue, its thickness measuring from 0.02 to 0.6mm, depending on the place of the capsule that was studied. The withdrawal of the immunosuppressive therapy did not allow the rebuilding of new capsules, and implant exchange with a valved device was needed, in order to recover IOP.
The use of chronic immunosuppressants may interfere with the capsule formation around the plates in non-valved drainage devices.Thus, in theses cases valved implants might be safer.
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