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Lukan P Mishev, Aneta Misheva, Anton Angelov, Misheva Ioanna, Yanita Tsankova; STARfloTM Glaucoma Implant for surgical treatment of primary open angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6143.
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To observe and determine the safety and long term results of the STARfloTM Glaucoma Implant for the surgical treatment of POAG
We have used the STARfloTM Glaucoma Implant for surgical treatment of POAG in 6 patients . It is made of STAR® biomaterial (100% medical grade silicone) with 11mm long x6mm wide and 275µm thick dimensions. The surgical technique is similar to the trabeculectomy ,but with no iridectomy and with creation of larger scleral flap ( 8mmx3mm ) . MMC of 5-FU were not used. We create communication with suprachoroidal space thru the sclera 2.5mm from the limbus (under the scleral flap ),then we insert the head of the implant in the anterior chamber and its body in the suprachoroidal space. Tight suturing of the scleral flap and conjunctiva.Preop and post-op included OCT ,ASOCT ,endothelial cell count and morphology and tonometry.
We have observed the patients in 1 year period ( 2 of them) and 6 months (all of them ).The mean preop IOP was 31.33mmHg and the mean postop IOP was 13.5mmHg .We have observed a stable trend for low IOP (11-14mmHg) without any medication. In the early post op period there was no shallow chamber ,hyphema ,hypotony ( less than 6mm) ,endothelial cell loss.The postop OCT show stable RNFL and GCC ,no endothelial cell loss (less than 5%) and no morphological changes ( stable hexagonality ) .No conjunctival bleb formation and no bleb complications. There was no choroidal detachment or any retinal complication in the postop period.
We think that the STARflo Glaucoma Implant is a promising alternative for surgical treatment of POAG .There is no need to use antimetabolites (MMC,5FU) because the STAR® material of the implant significantly reduces the scarification .We believe that in long term stability this device can be superior to other techniques because it does not rely on a bleb and prevents scar formation .Further investigation is needed since our results are based on small number of patients
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