Suprachoroidal silicone tube shunt implantation successful in glaucoma surgery

August 2, 2011

Suprachoroidal silicone tube drainage of aqueous humour effectively reduces intraocular pressure (IOP) in glaucoma patients

Suprachoroidal silicone tube drainage of aqueous humour effectively reduces intraocular pressure (IOP) in glaucoma patients, according to a study published in the Journal of Glaucoma.

Dr Metin Unal et al., Ulucanlar Eye Education and Research Hospital, Ankara, Turkey, studied 24 glaucomatous eyes that were unresponsive to medical treatment, including 7 eyes that underwent earlier trabeculectomy. A limbus-based scleral flap and a 1.5 mm deep sclerotomy adjacent to the flap opening was created. The posterior end of the tube was placed in the suprachoroidal space and the anterior end was put into the anterior chamber. IOP and best corrected visual acuities (BCVA) were measured preoperatively and postoperatively on the first day, then the first week and in the first, third, sixth, twelfth and eighteen months.

The tube was considered as a failure if postoperative IOP was greater than 21 mm Hg, lower than 5 mm Hg or if additional surgery was required. Eyes that did not require supplemental medical therapy were identified as a complete success. Eyes that had an IOP within the range, regardless of whether they had additional medical therapy, were considered as a qualified success.

After a mean postoperative follow-up period of 4.4±23.7 weeks, the mean IOP had significantly reduced compared to preoperative data. Results demonstrated a complete success rate of 95.8%±4.1 in the first week, 79.2%±8.3 in the first and the third months, and 63.3%±12.0 for the sixth and twelfth month. Qualified success rates were 95.8%±4.1 in the first week, 87.5%±6.8 in the first, third, sixth, twelfth months. Of the eyes studied, 7 were classed as failures and early hypotony was identified in 6 eyes. Intracameral bleeding was found in 2 patients and 3 patients experienced a fibrin reaction in the anterior chamber. There was no record of infection, choroidal or retinal detachment. The suprachoroidal silicone tube shunt implantation is a safe and effective treatment for glaucoma patients.