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Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush

Objective: To assess the utility of viscoelastic injection to induce bleb expansion and decrease intraocular pressure (IOP) in eyes with encapsulated glaucoma tube shunt blebs. Design: Case series. Subjects and participants: Forty-three glaucomatous eyes, including 13 eyes with congenital, 13 uveiti...

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Autores principales: Groth, Sylvia L, Greider, Kelsi L, Sponsel, William Eric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779944/
https://www.ncbi.nlm.nih.gov/pubmed/26997840
http://dx.doi.org/10.5005/jp-journals-10008-1188
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author Groth, Sylvia L
Greider, Kelsi L
Sponsel, William Eric
author_facet Groth, Sylvia L
Greider, Kelsi L
Sponsel, William Eric
author_sort Groth, Sylvia L
collection PubMed
description Objective: To assess the utility of viscoelastic injection to induce bleb expansion and decrease intraocular pressure (IOP) in eyes with encapsulated glaucoma tube shunt blebs. Design: Case series. Subjects and participants: Forty-three glaucomatous eyes, including 13 eyes with congenital, 13 uveitic, 5 neovascular, 5 open angle, 4 narrow angle and 3 traumatic glaucomas. Methods, interventions or testing: All patients underwent viscoelastic flush procedure. A pre-bent 27 or 30-gauge cannula was passed through a 25-gauge paracentesis, advanced over the iris across the anterior chamber, and insinuated into the tube shunt lumen. Once the cannula was firmly lodged in position, 0.45 to 0.85 ml of viscoelastic was injected to hyperinflate the bleb. Main outcome measures: Paired t-tests were performed comparing preoperative IOP and number of medications used preoperatively vs levels measured at 1, 6, 12, 18 and 24 months. Results: Intraocular pressure was reduced from a mean preoperative level of 26.0 ± 1.2 (sem) mm Hg to 15.8 ± 1.0 at 1 month, remaining stable thereafter at each 6-month interval with 15.1 ± 1.1 mm Hg at 24 months (p < 0.0001). Medication use did not vary significantly from baseline. Pressure remained < 21 mm Hg after 2 years in 85% of eyes cannulated within 1 year of primary tube shunt implantation (n = 23), and in 62% of eyes cannulated more than 1 year after tube shunt placement (n = 20). Conclusion: Tube shunt expansion with bolus viscoelastic flush successfully restored encapsulated bleb function, providing a substantial (~10 mm Hg) IOP decrease into the mid-normal pressure range. This persisted in the majority of treated eyes for the entire study period. How to cite this article: Groth SL, Greider KL, Sponsel WE. Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush. J Curr Glaucoma Pract 2015;9(3):73-76.
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spelling pubmed-47799442016-03-18 Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush Groth, Sylvia L Greider, Kelsi L Sponsel, William Eric J Curr Glaucoma Pract Research Article Objective: To assess the utility of viscoelastic injection to induce bleb expansion and decrease intraocular pressure (IOP) in eyes with encapsulated glaucoma tube shunt blebs. Design: Case series. Subjects and participants: Forty-three glaucomatous eyes, including 13 eyes with congenital, 13 uveitic, 5 neovascular, 5 open angle, 4 narrow angle and 3 traumatic glaucomas. Methods, interventions or testing: All patients underwent viscoelastic flush procedure. A pre-bent 27 or 30-gauge cannula was passed through a 25-gauge paracentesis, advanced over the iris across the anterior chamber, and insinuated into the tube shunt lumen. Once the cannula was firmly lodged in position, 0.45 to 0.85 ml of viscoelastic was injected to hyperinflate the bleb. Main outcome measures: Paired t-tests were performed comparing preoperative IOP and number of medications used preoperatively vs levels measured at 1, 6, 12, 18 and 24 months. Results: Intraocular pressure was reduced from a mean preoperative level of 26.0 ± 1.2 (sem) mm Hg to 15.8 ± 1.0 at 1 month, remaining stable thereafter at each 6-month interval with 15.1 ± 1.1 mm Hg at 24 months (p < 0.0001). Medication use did not vary significantly from baseline. Pressure remained < 21 mm Hg after 2 years in 85% of eyes cannulated within 1 year of primary tube shunt implantation (n = 23), and in 62% of eyes cannulated more than 1 year after tube shunt placement (n = 20). Conclusion: Tube shunt expansion with bolus viscoelastic flush successfully restored encapsulated bleb function, providing a substantial (~10 mm Hg) IOP decrease into the mid-normal pressure range. This persisted in the majority of treated eyes for the entire study period. How to cite this article: Groth SL, Greider KL, Sponsel WE. Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush. J Curr Glaucoma Pract 2015;9(3):73-76. Jaypee Brothers Medical Publishers 2015 2016-02-02 /pmc/articles/PMC4779944/ /pubmed/26997840 http://dx.doi.org/10.5005/jp-journals-10008-1188 Text en Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd. This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/
spellingShingle Research Article
Groth, Sylvia L
Greider, Kelsi L
Sponsel, William Eric
Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush
title Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush
title_full Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush
title_fullStr Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush
title_full_unstemmed Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush
title_short Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush
title_sort utility of operative glaucoma tube shunt viscoelastic bolus flush
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779944/
https://www.ncbi.nlm.nih.gov/pubmed/26997840
http://dx.doi.org/10.5005/jp-journals-10008-1188
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