Abstract
Purpose:
To characterize early postoperative intraocular pressure (IOP) after Baerveldt 350 (BGI) aqueous shunt modified with a novel venting stitch (VS) technique.
Methods:
Retrospective chart review of 67 eyes of 64 patients receiving BGI 350 with VS (VS group) or BGI 350 without fenestration (control group). In the VS group, a 10-0 nylon suture is passed through the BGI tube lumen and sutured through superficial clear cornea. Data on IOP, number of medications and hypotony (IOP<5mmHg) was collected for the following periods: immediate preoperative (preop), postoperative day 1 (POD1), postoperative but pre-functioning bleb (postop pre-bleb), and immediate post-tube opening (post-tube opening). Fisher’s Exact and Mann-Whitney U tests were used for statistical analysis.
Results:
For patients with preoperative 15mmHg<IOP≤30mmHg, mean preop IOP in the VS group was 21.2±4.7mmHg (15 eyes) and control group was 24.1±3.8mmHg (18 eyes; p=.057). Mean POD1 IOP in the VS group was 13.6±6.4mmHg and control group was 24.3±11.1mmHg (p=.003). Mean postop pre-bleb IOP in the VS group was 16.1±5.6mmHg and control group was 22.3±6.1mmHg (p=.002). Mean number of postoperative IOP-lowering medications in the VS group was 0.6±0.9 and control group was 3.1±1.5 (p<.001). Mean post-tube opening IOP in the VS group was 13.1±6.1mmHg and control group was 12.9±6.0mmHg (p=.837). For patients with preoperative IOP>30mmHg, mean preop IOP in the VS group was 40.9±5.4mmHg (9 eyes) and control group was 40.1±7.0mmHg (25 eyes; p=.596). Mean POD1 IOP in the VS group was 14.6±11.6mmHg and control group was 25.4±16.7 (p=.099). Mean postop pre-bleb IOP in the VS group was 14.2±6.5mmHg and control group was 23.5±11.9mmHg (p=.029). Mean number of postoperative IOP-lowering medications in the VS group was 1.2±1.6 and control group was 2.2±1.9 (p=.149). Mean post-tube opening IOP in the VS group was 15.0±7.0mmHg and control group was 14.6±8.3mmHg (p=.781). Of the 67 eyes, hypotony occurred in 3 (12.5%) eyes in the VS group and 6 (14.0%) eyes in control group (p=1.000). 1 hypotonous eye had the venting stitch pulled after choroidals developed leading to resolution of the choroidals.
Conclusions:
This novel venting stitch modification provides better IOP control in the early postoperative period before the BGI becomes functional, reducing the number of IOP-lowering medications required. Venting stitch modification did not increase the frequency of postoperative hypotony.
Keywords: 568 intraocular pressure •
421 anterior segment