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M.E. Yablonski; Internal Tube Shunt From Anterior Chamber to Suprachoroidal Space: A Novel Glaucoma Surgery . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1223.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To evaluate a new method of shunting aqueous to the suprachoroidal space for the purpose of lowering IOP. Methods: An internal tube silicone shunt procedure to the suprachoroidal space was done in 56 glaucoma eyes. 15 underwent shunting directly from the anterior chamber. 41 underwent shunting from a deep scleral lake as has been previously described1. Results: The mean ± S.D. values for the anterior chamber shunted eyes were 33.2 ± 9.8 mm Hg on 3.4 meds at baseline and 13.6 ± 5.1 mm Hg on 1.7 meds after a follow–up time of 6.1 ± 3.2 months. Postoperative tonographic outflow facility, Cton, was 0.16 ul/min/mm Hg, unchanged from the preoperative value. Decrease in IOP after topical CAI and timolol was 11.2 ± 4.1 mm Hg and 11.3 ± 4.2 mm Hg, respectively. Results of the shunts from the deep scleral lake were similar to those previously described1, with little loss of effect after an additional 12 month follow–up. Conclusions: Shunting aqueous humor with a silicone tube from the anterior chamber to the suprachoroidal space is an effective means of lowering IOP. It enhances the effect of topical CAI and timolol, presumably by improving access to the ciliary body. This suggests that the tube could also be used to improve access of topical meds to the posterior uvea to treat chorio–retinal diseases now requiring intravitreal injections. 1. Yablonski ME. Trabeculectomy with internal tube shunt. J Glaucoma.2005: in press.
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