Purchase this article with an account.
Z. Ahmad, T. Mahmoud; Effect of Tube Shunts on Intraocular Pressure Control in Chronic Uveitic Glaucoma After Retisert Implantation. Invest. Ophthalmol. Vis. Sci. 2009;50(13):298.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To assess intraocular pressure (IOP) control after Fluocinolone Acetonide intravitreal implant (Retisert, Bausch & Lomb) in patients with uveitic glaucoma with previously or concomitantly placed glaucoma tube shunts.
A retrospective chart review of all patients who had Retisert implants for posterior non-infectious uveitis subsequent to or combined with tube shunts between 9/07 and 10/08 was performed. The main outcome measure was postoperative intraocular pressure control.
Five eyes of 3 patients, 2 males and a female, ages 38 to 63, satisfied the inclusion criteria. Four eyes had prior anterior chamber tube shunts, of these, 2 tubes were repositioned from the anterior chamber to the pars plana at the time of Retisert implantation. One eye had a new Ahmed valve inserted into the pars plana at the time of Retisert placement. Extracapsular cataract extraction with PCIOL insertion was performed in 3 eyes, and pars plana vitrectomy was performed in 4 eyes, including the 3 with pars plana tube insertion, and at the time of Retisert implantation. All eyes were pseudophakic post Retisert implant. Intraocular pressure in the 2 eyes with anterior chamber tubes improved from 22 and 13 to 10 and 8 respectively on no glaucoma medications 7 months post-op. The 2 eyes in which tube shunts were repositioned to the pars plana and the eye with a new pars plana tube shunt maintained stable IOP but required fewer glaucoma medications 8 months and 2 months post-op respectively; Betimol, Alphagan and Azopt in the 2 eyes and Combigan in the third eye pre-op versus intermittently used Betimol and Alphagan due to poor compliance in the 2 eyes and Alphagan in the third eye post-op. Three eyes had improved visual acuity (HM to 20/40, HM to 20/30, and 20/400 to 20/60), one eye had worse Va (20/80 to 20/200) and one eye maintained stable Va (20/200) 2-9 months post-op. Two patients (3 eyes) were taking Prednisone 80 mg daily pre-op; one patient was tapered to Prednisone 5 mg daily at 8 months post-op and one to 60 mg daily at 2 months post-op with good control of inflammation. One patient (2 eyes) was on Imuran and Enbrel preop with minimal inflammation; these were discontinued postop without an increase in inflammation.
This PDF is available to Subscribers Only