Abstract
ABSTRACTAimTo describe postoperative surgical success of either Ahmed or Baerveldt tube shunt implantation for eyes with medically uncontrolled traumatic glaucoma.Materials and methodsA review was carried out to identify patients with traumatic glaucoma that required tube shunt implantation between 2009 and 2015 at Rutgers University in Newark, New Jersey, USA. Seventeen eyes from 17 patients met inclusion criteria, including at least 3-month postoperative follow-up. The main outcome measure was surgical success at 1-year follow-up after tube implantation.ResultsMean preoperative intraocular pressure (IOP) was 34.1 ± 8.2 mm Hg on 3.1 ± 1.6 ocular hypotensive medications. Nine eyes (53%) sustained closed globe injury. Ten eyes (59%) received an Ahmed valve shunt and seven eyes (41%) received a Baerveldt tube shunt. Surgical success rate at 1 year postoperatively was 83%. Compared to preoperative, the mean postoperative IOP was significantly lower (16.1 ± 3.5 mm Hg, p < 0.001) on significantly fewer ocular hypertensive medications (1.3 ± 1.6, p = 0.001) at a mean follow-up of 10 months. Mean IOP reduction at last follow-up was 49%. There were three cases of surgical failures: One case of hypotony, one case of tube extrusion with subsequent explan-tation, and one case requiring second tube insertion for IOP control.ConclusionImplantation of an Ahmed or Baerveldt tube shunt provided successful control of IOP in patients with medically uncontrollable traumatic glaucoma.How to cite this articleYadgarov A, Liu D, Crane ES, Khouri AS. Surgical Outcomes of Ahmed or Baerveldt Tube Shunt Implantation for medically Uncontrolled Traumatic Glaucoma. J Curr Glaucoma Pract 2017;11(1):16-21.
Highlights
Globe trauma is a known cause of secondary glaucoma
While successful control of intraocular pressure (IOP) in traumatic glaucoma has been clearly demonstrated with Molteno tube shunt implantation, surprisingly there are very few studies that report surgical outcomes after Ahmed or Baerveldt tube implantation for traumatic glaucoma, with the largest series consisting of six cases.[5,15]
A retrospective chart review was conducted on patients who were diagnosed with traumatic glaucoma and underwent tube shunt implantation during the period from January 2009 to January 2015 at Rutgers University Hospital
Summary
Elevated intraocular pressure (IOP) can develop after globe injury through different possible mechanisms, which include hyphema, synechial angle closure, lens injury, direct trabecular meshwork injuries with or without angle recession, and inflammation.[1] The overall incidence of traumatic glaucoma has been reported to be 2 to 17%, depending on follow-up and diagnostic criteria.[2,3,4,5] Management is aimed at preventing further damage to the injured eye. Tube shunt surgery is an appropriate option due to acceptable IOP success rates without an increased risk for infection.[14,15] While successful control of IOP in traumatic glaucoma has been clearly demonstrated with Molteno tube shunt implantation, surprisingly there are very few studies that report surgical outcomes after Ahmed or Baerveldt tube implantation for traumatic glaucoma, with the largest series consisting of six cases.[5,15] Our case series is the largest to date to report on surgical outcomes of eyes with traumatic glaucoma that underwent either Ahmed or Baerveldt tube shunt implantation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
