The Evolution of Glaucoma Drainage Implants.

Petera Netland,Franks Ashburn

doi:10.4103/jovr.jovr_26_18

Petera Netland, Franks Ashburn

Open Access

https://doi.org/10.4103/jovr.jovr_26_18

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Abstract

The modern glaucoma drainage implant era was initiated with implantation of a plate posterior to the limbus connected to the anterior chamber by a long silicone tube. Non-restrictive (Molteno and Baerveldt implants) and flow-restrictive (Ahmed Glaucoma Valve) implants were developed. With increased clinical experience, variables influencing success and failure of glaucoma drainage implant surgery were better understood. In an iterative process, complications were reduced and indications for drainage implant surgery were broadened. Growth of utilization of glaucoma drainage implants has dramatically increased in recent years. Glaucoma drainage implants have improved the prognosis for surgical success for refractory glaucoma, and have a well-established role in the surgical treatment of glaucoma.

Highlights

The Discovery PeriodThe use of setons to “wick” aqueous humor from the anterior chamber dates back to 1906, with horsehair being used to drain aqueous humor via paracentesis.[1]
In the 1960s and 1970s, Dr Anthony Molteno pioneered the development of a tube shunt implant, with a plate implanted posterior to the limbus and connected to the anterior chamber by a long silicone tube, thereby initiating the modern glaucoma drainage implant era.[2,3,4,5]
Dr Mateen Ahmed developed the Ahmed Glaucoma Valve (New World Medical, Rancho Cucamonga, CA, USA), which was introduced for clinical use in 1993.[8]. The Ahmed Glaucoma Valve (AGV) comprises two thin silicone elastomer membranes positioned in a Venturi‐shaped chamber

Summary

The Discovery Period

The use of setons to “wick” aqueous humor from the anterior chamber dates back to 1906, with horsehair being used to drain aqueous humor via paracentesis.[1]. In the 1960s and 1970s, Dr Anthony Molteno pioneered the development of a tube shunt implant, with a plate implanted posterior to the limbus and connected to the anterior chamber by a long silicone tube, thereby initiating the modern glaucoma drainage implant era.[2,3,4,5]

Development of Variations in Devices and Techniques

Clinical Experience and Refinement of Techniques

The Growth of Clinical Utilization

Findings

The Future