Early Intraocular Pressure Control Via Capsule Revision of a Failed Valved Aqueous Shunt During Concurrent Placement of a Nonvalved Aqueous Shunt
| Autor: | Christos Theophanous, Mary Qiu, Saira Khanna, Zhuangjun Si |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Intraocular pressure Triamcinolone acetonide Visual acuity genetic structures medicine.medical_treatment Glaucoma medicine Trabeculectomy Humans In patient Glaucoma Drainage Implants Intraocular Pressure Aged 80 and over business.industry Capsule Aqueous shunt General Medicine medicine.disease eye diseases Surgery Treatment Outcome sense organs medicine.symptom business Glaucoma Open-Angle medicine.drug |
| Zdroj: | Ophthalmology. Glaucoma. 5(2) |
| ISSN: | 2589-4196 |
| Popis: | Purpose To describe the novel strategy of performing a concurrent capsule revision of a failed pre-existing valved aqueous shunt with implantation of an additional nonvalved aqueous shunt for early postoperative intraocular pressure (IOP) control. Design Case report of a single patient. Results An 87-year-old man with severe primary open-angle glaucoma in both eyes presented to our clinic. His pseudophakic left eye had a failed superonasal trabeculectomy and an encapsulated superotemporal Ahmed FP7 (New World Medical) aqueous shunt in the anterior chamber. He had previously undergone micropulse cyclophotocoagulation 3 times and excisional goniotomy. Visual acuity in his left eye was 20/30, and IOP was 24 mmHg on 4 topical IOP-lowering medications. An inferonasal Baerveldt 350 (Advanced Medical Optics) aqueous shunt was placed with concurrent revision of the Ahmed capsule. A large block of capsule tissue was excised from the surface of the plate, and 20 mg of subtenon triamcinolone acetonide (Kenalog, Bristol-Myers Squibb) was injected overlying the plate. His IOP ranged between 6 and 15 mmHg in the immediate postoperative period. There were no hypotony-associated complications at any time point. At postoperative month 18, his IOP was 10 mmHg on zero medications. Conclusions In patients with a failed valved aqueous shunt undergoing an additional nonvalved aqueous shunt, a concurrent capsule revision of the valved aqueous shunt can provide early IOP lowering before the nonvalved tube opens. |
| Databáze: | OpenAIRE |
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