Early Intraocular Pressure Control Via Capsule Revision of a Failed Valved Aqueous Shunt During Concurrent Placement of a Nonvalved Aqueous Shunt.

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. Case report of a single patient. 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. 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. Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Citation

Zhuangjun Si, Christos Theophanous, Saira Khanna, Mary Qiu. Early Intraocular Pressure Control Via Capsule Revision of a Failed Valved Aqueous Shunt During Concurrent Placement of a Nonvalved Aqueous Shunt. Ophthalmology. Glaucoma. 2022 Mar-Apr;5(2):229-232

Mesh Tags

PMID: 34500122

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