Abstract
Purpose :
The purpose of this retrospective study is to compare early postoperative intraocular pressures (IOP) of patients who underwent Baerveldt 350mm aqueous drainage device implantation who at the time of surgery had placement of either a 9-0 polyglactin “wick” suture or Sherwood slits proximal to the ligature suture.
Methods :
This is a retrospective case-control study to compare the postoperative IOPs of 37 patients who undergone Baerveldt tube surgery with either having Sherwood slits (n=19) or a 9-0 polyglactin “wick” suture (n=18) made proximal to an occlusive 6.0 polyglactin absorbable suture. All patients had placement of a full-length intraluminal occluding 3.0 polyamide stent suture (Supramid, S Jackson Inc., Alexandria, VA, USA). Patients were identified using the Medisoft ™ electronic patient record. Data on IOPs, number of glaucoma drops (NGD) and number of patients on acetazolamide (NPA) were collected at baseline, day 1, week 1, month 1 and month 2 post-operatively. Statistical significance was set at p<0.05.
Results :
The mean baseline IOP, NGD and NPA in the wick and Sherwood slit groups were 29.9±13, 3.5±0.9, 11 and 33.2±14.6, 3.4±1, 10, respectively (p>0.05).
The mean IOP and percentage of reduction were lower in the wick group compared to the Sherwood slit group on every follow-up appointment, reaching statistical significance only on day 1 for IOP (10.5±10.4 compared to 25.5±14.8 p=0.01, respectively) and on week 1 for both (16±9.9 and 41.1% compared to 27.9±13.9 p<0.01 and 8.3% p=0.01, respectively). The mean IOP in the wick group at 1 and 2 months follow-up were 23.4±6.4 and 21.8±7 compared to 27.3±13.8 and 27.6±14 in the Sherwood slit group (p>0.05).
The mean NGD and NPA were also lower in wick group at all follow up time points, reaching statistical significance at week 1 only (0.7 and 0 compared to 2.3 p<0.01 and 4 p=0.02, respectively). The mean NGD in the wick group at 1 and 2 months follow-up were 2±1.5 and 1.8±1.6 compared to 2.7±1.4 and 2.4±1.5 in the Sherwood slit group (p>0.05).
Conclusions :
This retrospective case review suggests the use of a 9-0 vicryl wick at the time of Baerveldt tube procedure may be an efficacious way of controlling IOP in the early post operative period, although future, larger prospective studies evaluating this would be beneficial.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.