REFRACTORY GLAUCOMA SURGICAL TREATMENT WITH LEUCOSAPPHIRE DRAINAGE DEVICE IMPLANTATION
Abstract
PURPOSE: To increase the efficiency of refractory glaucoma surgical treatment.
METHODS: A retrospective study of 29 patients (29 eyes) with refractory glaucoma, who underwent the original leucosapphire drainage implantation («VIM», SaintPetersburg). Most patients (25 eyes — 86.2%) had primary open-angle glaucoma and have been repeatedly operated previously. 2 patients (6.9%) had traumatic glaucoma, and 2 patients (6.9%) had neovascular glaucoma. The average IOP before surgery was 32.4Ѓ}0.7 mm Hg. All IOP measurements were conducted by means of Maklakov tonometry with 10 g weights. Follow up period varied from 1 to 8 years.
RESULTS: After the implantation of leucosapphire drainage, IOP level significantly decreased from 32.4Ѓ}0.7 mm Hg to 14.8Ѓ}1.0 mm Hg. In 1 month after drainage implantation mean IOP was 19.3Ѓ}1.0 mm Hg, after 3 months it equaled 19.8Ѓ}0.9 mm Hg, after 6 months — 20.0Ѓ}0.9 mm Hg, one year after surgery — 20.5Ѓ}0.9 mm Hg. IOP was below 26.0 in 89.6% cases, in 37.9% of which no additional medication had been administered. Compensation at the IOP level of ≤22.0 mm Hg was noted in 75.9% of cases. Visual field test was stable in 69.0% of patients. The following postoperative complications were registered in our study: a shallow anterior chamber (17.2%), hypertension episode (20.7%), hyphema (17.2%), ciliochoroidal detachment (17.2%), external filtration (10.3%), uveal reaction (6.9%).
CONCLUSION: Leucosapphire drainage device implantation may be considered an alternative method of effective surgical treatment of patients with refractory forms of glaucoma.
About the Authors
M. A. Kladko
I.I. Mechnikov North-Western state medical University;
District Glaucoma center
Russian Federation
Russian Federation
Resident, Ophthalmologist of the District Glaucoma Center
41 Kirochnaya street, Saint-Petersburg, 191015, 5, 1, lit. A. St. Simonov, Saint-Petersburg, 194358
М. M. Pravosudova
Sv. Fyodorov’s Eye Microsurgery Federal State Institution, Saint-Petersburg department
Russian Federation
Russian Federation
Ph.D.
21 Yaroslava Gasheka street, St. Petersburg, 192283
V. V. Naumenko
Sv. Fyodorov’s Eye Microsurgery Federal State Institution, Saint-Petersburg department
Russian Federation
Russian Federation
Ph.D., Head of Science and Education Department
21 Yaroslava Gasheka street, St. Petersburg, 192283
References
1. Astakhov Yu.S., Egorov E.A., Astakhov S.Yu., Brezel Yu.A. Surgical treatment of refractory glaucoma. Clinical Ophthalmology 2006; 7 (1): 25-27. (In Russ.). doi.org/10.17816/OV201313-8.
2. Alekseyev V.N., Levko M.A., Hamed S.M., Essam T. Surgical treatment of refractory glaucoma. Ophthalmology J 2011; 4(3):65-69. (In Russ.).
3. Erichev V.P. Refractory glaucoma. Vestn Ophthalmol 2000; (5):8-10. (In Russ.).
4. Bessmertny A.M. Risk factors of excessive scarring in patients with primary open-angle glaucoma. Glaucoma 2005; 3:34-36. (In Russ.).
5. Bessmertny A.M., Chervyakov A.Yu. The use of implants in treatment of refractory glaucoma. Glaucoma 2001; 1:44-47. (In Russ.).
6. Takhchidi Kh.P., Cheglakov V.Yu. Refractory glaucoma drainage devices. Review. Refractive surgery and ophthalmology 2009; 9(3):11-16. (In Russ.).
7. Astakhov S.Yu., Harsha A.A. An effective method of surgical treatment of refractory glaucoma patients using Ex-PRESS TM filtering device. Ophthalmology J 2013; 6(1): 3-8. (In Russ.). doi.org/10.17816/OV201313-8.
8. Coupin A., Li Q., Riss I. Ex-PRESS miniature glaucoma implant inserted under a scleral flap in open-angle glaucoma surgery: a retrospective study. J Fr Ophtalmol 2007; 30(1):18-23. doi.org/ 10.1016/S0181-5512(07)89545-3.
9. Christakis P.G., Kalenak J.W. The Ahmed Versus Baerveldt study: one-year treatment outcomes. Ophthalmology 2011; 118(11): 2180-2189. doi.org/10.1016/j.ophtha.2011.05.003.
10. Kanner E.M., Netland P.A., Sarkisian S.R.Jr., Du H. Ex-PRESS miniature glaucoma device implanted under a scleral flap alone or combined with phacoemulsification cataract surgery. J Glaucoma 2009; 18(6):488-491. doi.org/10.1097/ijg.0b013e31818fb44e.
11. Mariotti C., Dahan E., Nicolai M., Levitz L., Bouee S. Long-term outcomes and risk factors for failure with the EX-press glaucoma drainage device. Eye (Lond.) 2014; 28(1):1-8. doi.org/10.1038/ eye.2013.234.
12. Melamed S., Ben Simon G.J., Goldenfeld M., Simon G. Efficacy and safety of gold micro shunt implantation to the supraciliary space in patients with glaucoma: a pilot study. Arch Ophthalmol 2009; 127(3):264-269. doi.org/10.1001/archophthalmol. 2008.611.
13. Netland P.A. et al. Randomized, prospective, comparative trial of EX-PRESS glaucoma filtration device versus trabeculectomy (XVT Study). Am J Ophthalmol 2014: 157(2):433-440. doi.org/ 10.1016/j.ajo.2013.09.014.
14. Wang W., Zhou M., Huang W. et al. Ex-PRESS implantation versus trabeculectomy in uncontolled glaucoma: a meta-analysis. PLoS One 2013; 31(5):63-69. doi.org/10.1371/journal.pone.0063591.
15. Dzhumova M.F., Marchenko L.N., Dzhumova A.A. EX–PRESS bypass implantation in refractive glaucoma surgery. RMJ Clinical Ophthalmology 2012; 4:142-143. (In Russ.).
16. Naumenko V.V., Balashevich L.I., Kachurin A.E. Leucosapphire explantodrainage implantation in hypotensive surgery of refractory POAG patients. Vestnik OGU 2012; 12(148):144-147. (In Russ.).
17. Sakhnov S.N., Naumenko V.V., Volik S.A., Malishev A.V., Volik E.I. A metod of refractory glaucoma surgical treatment. Glaucoma 2013; 1:29-34. (In Russ.).
Review
For citations:
Kladko M.A., Pravosudova М.M., Naumenko V.V. REFRACTORY GLAUCOMA SURGICAL TREATMENT WITH LEUCOSAPPHIRE DRAINAGE DEVICE IMPLANTATION. National Journal glaucoma. 2017;16(4):44-50. (In Russ.)
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