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G. Olea Zorita, J. Garcia Feijoo, J. Martinez de la Casa, C. Mendez Hernandez, A. Fernandez Vidal, F. Saenz-Frances, J. Rodriguez del Valle, M. Jerez Fidalgo, M. Jimenez Santos, J. Garcia Sanchez; Fluorophotometric Study of the Suprachoroidal Shunt Gold Micro Shunt in Patients With Refractory Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):457.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the hypotensive efficacy of the suprachoroidal shunt and its effect on aqueous humor outflow facility in patients with previously failed filtering glaucoma surgery.
Prospective study in 17 eyes of 17 patients diagnosed with primary open angle glaucoma (POAG 66.7%), cronic angle closure glaucoma (GACG 11.1%), pseudoexfoliative glaucoma (PEXG 1.1%), primary congenital glaucoma (PCG 5.6%) and inflammatory glaucoma (IG 5.6%). All patients were treated with maximum medical therapy and had undergone at least one filtering glaucoma surgery which had failed by the time of recluitment. A suprachoroidal drainage device, Gold Micro Shunt (GMS) was implanted in either the superonasal or superotemporal quadrant through a scleral incission. Intraocular pressure (IOP) was measured using a Goldmann applanation tonometer and outflow facility was calculated out of anterior chamber fluorophotometry. We present results at twelve months follow-up.
Mean filtering glaucoma surgeries prior to the shunt implantation was 1.4 ± 0.8. Mean preoperative IOP was 21.87 ± 3.87 mmHg. Mean preoperatory topical hypotensive drugs was 2.52 ± 0.94. Three patients were also treated with systemic acetazolamide. IOP during follow-up was 12.37 ± 7.4 mmHg one week after surgery (p=0.001), 19.25 ± 5.83 at first month (p=0.155), 17.62 ± 3.68 at three months (p=0.003) and 17.93 ± 4.98 mmHg at twelve months (p=0.027). One year after surgery, mean topical treatment required was 1.76 ± 0.97 (p=0.043) (2 patients did not need treatment). One patient was treated with systemic acetazolamide by the end of follow-up. Aqueous humor outflow facility prior to surgery was 0.162 ± 0.1, and 0.844 ± 0.54 by the end of follow-up (p=0.004). No severe complications happened.
Suprachoroidal shunt is effective at mid-time lowering IOP and treatment needs in patients with refractory glaucoma. The increase in aqueous humor outflow facility supports this fact.
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