March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Systematized Stenting of Baerveldt Shunts: techniques to reduce early post-operative hypotony
Author Affiliations & Notes
  • Cyrielle H. Bela
    Ophtalmology, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
  • Justyna D. Oleszczuk
    Ophtalmology, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
  • Lorenzo Franscini
    Ophtalmology, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
  • Ciara Bergin
    Ophtalmology, Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland
  • Eamon Sharkawi
    Glaucoma, Jules Gonin Eye Hospital, Lausanne, Switzerland
  • Footnotes
    Commercial Relationships  Cyrielle H. Bela, None; Justyna D. Oleszczuk, None; Lorenzo Franscini, None; Ciara Bergin, None; Eamon Sharkawi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3708. doi:https://doi.org/
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      Cyrielle H. Bela, Justyna D. Oleszczuk, Lorenzo Franscini, Ciara Bergin, Eamon Sharkawi; Systematized Stenting of Baerveldt Shunts: techniques to reduce early post-operative hypotony. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3708. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To investigate the effect of the systematized use of intraluminal stents in Baerveldt shunts (BS) on early postoperative IOP control and complication rates.

Methods: : One hundred and twenty eyes with medically uncontrolled glaucoma were prospectively recruited to undergo BS implantation at Jules Gonin Eye Hospital, Switzerland. Baerveldt shunts were stented (full-length of the intraluminal tube) using a Supramid® 3.0 suture. A minority of shunts (37%) were also ligated intraoperatively and laser suture lysis performed postoperatively. Stent removals, either partial (retraction of 5mm) or complete, were carried out according to a predetermined protocol. Surgery was considered a success when IOP was ≤ 21mmHg and a minimum of 20% reduction from baseline was achieved with/without glaucoma medication (GMs). Hypotony related complications were defined as: choroidal effusions, shallow AC, hypotonous maculopathy or IOP≤5mmHg for over 2 weeks.

Results: : Mean age was 61.8 years (± standard deviation; ±21.5). Mean follow-up was 17.1 (±7.9) months. Mean preoperative IOP was 26.9 mmHg; mean IOP on the last visit 13.2 mmHg (p<0.001). At year one, the success rate was 87%. In 90% of eyes, IOP was ≤18 mmHg at last visit. Mean number of preoperatively GMs was 3.1; postoperatively 1.4 (p<0.001). Stent removals were performed in 87% of eyes (24% partial; 61% complete). 13% of eyes required no stent removal to reach target IOP. Complications were minor and infrequent (16%) and only 7% were hypotony related.

Conclusions: : Systematized use of intraluminal stents with Baerveldt aqueous shunts resulted in gradual and controlled IOP lowering with minimal hypotony-related complications. This may have important implications on clinical practice, given the rising rates of aqueous shunt implantation.

Keywords: intraocular pressure 
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