March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Baerveldt Aqueous Shunt Implantation Into The Ciliary Sulcus
Author Affiliations & Notes
  • Ciara Bergin
    Glaucoma, Jules Gonin Eye Hospital, Lausanne, Switzerland
  • Farid Achache
    Glaucoma, Jules Gonin Eye Hospital, Lausanne, Switzerland
  • Sorana Andrei
    Glaucoma, Jules Gonin Eye Hospital, Lausanne, Switzerland
  • Eamon Sharkawi
    Glaucoma, Jules Gonin Eye Hospital, Lausanne, Switzerland
  • Footnotes
    Commercial Relationships  Ciara Bergin, None; Farid Achache, None; Sorana Andrei, None; Eamon Sharkawi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3719. doi:https://doi.org/
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      Ciara Bergin, Farid Achache, Sorana Andrei, Eamon Sharkawi; Baerveldt Aqueous Shunt Implantation Into The Ciliary Sulcus. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3719. doi: https://doi.org/.

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

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Abstract
 
Purpose:
 

Aqueous shunt implantation into the anterior chamber is associated with corneal decompensation in up to a third of eyes. Intracameral tube position may affect corneal endothelial cell loss. The authors set out to examine the efficacy and safety of Baerveldt shunt implantation into the ciliary sulcus combined with surgical peripheral iridectomy (SPI).

 
Methods:
 

One hundred eyes prospectively underwent Baerveldt shunt implantation into the cilliary sulcus combined with SPI, leaving a short intracameral tube length (1-2mm). Pre and post operative measures recorded included patient demographics, visual acuity, IOP, number of glaucoma medications (GMs) and all complications. Pre-existing corneal decompensation was recorded. Success was defined as IOP≤21mmHg and 20% reduction in IOP from baseline with or without GMs.

 
Results:
 

Mean age was 65.4 years (±20.4years). Mean follow-up was 10.8 months. Preoperatively IOP was 25.7mmHg (± 9.9mmHg), GMs were 2.9 (±1.2) and VA was 0.4 (±0.3). At one year postoperatively there was a significant drop in IOP (mean= 13.3mmHg (± 5.0mmHg); p<0.001) and number of GMs (mean= 1.3 (±1.4); p<0.001); and no significant change in VA (mean= 0.4 (±0.3); p=0.93). The success rate at one year was 83%. Complications were minor and non sight threatening (10%), there were no cases of postoperative corneal decompensation, tube blockage or iris/corneal-tube contact.

 
Conclusions:
 

The results demonstrate that placement of Baerveldt shunts into the ciliary sulcus with SPI is a safe and efficacious method of IOP reduction in comparison with standard shunt positioning in the anterior chamber. The intracameral tube position combined with SPI avoided tube-iris contact and corneal decompensation. Sulcus placement of aqueous shunts should be considered in pseudophakic eyes.

 
Keywords: cornea: endothelium • aqueous 
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