Timing and postoperative outcomes of supramid removal after Baerveldt tube (BVT) surgery in a UK tertiary referral centre

Session Details

Session Title: Presented Poster Session: Glaucoma II

Venue: Poster Village: Pod 3

First Author: : F.Stringa UK

Co Author(s): :    R. Chen   P. Agrawal                    

Abstract Details

Purpose:

Long-term data of postoperative management following BVT surgery is currently limited. This study aims to evaluate the outcome and the safety profile of supramid removal after BVT surgery for refractory glaucoma. This has been performed by a single consultant surgeon in a UK tertiary centre. Follow-up at 3 years looked at IOP, safety profile and postoperative medication reduction.

Setting:

This is prospective study of 37 patients undergoing BVT from 2014-2018 at Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK

Methods:

Patients underwent BVT surgery with 0.4mg/ml Mitomycin C (MMC), a 3/0 intraluminal suture (supramid) insertion and 10/0 nylon external ligation suture(s). Postoperative argon suture lysis and supramid removal were performed as indicated. Follow-up assessments looked at intraocular pressure (IOP) complications and postoperative glaucoma medications reduction. Hypotony was defined as IOP below 5 mmHg.

Results:

Preoperatively, mean IOP was 30±7.9mmHg with 3.5±0.7 antiglaucoma medications. Mean postoperative IOP reduction at 12,24 and 36 months was 48.3%, 51.7% and 54% respectively. Mean percentage reduction in postoperative drops at the same time points was 68.6%, 62.9% and 60% respectively. 22 patients (59.5%) required supramid removal within 12 months, with mean preoperative IOP of 30.9±12.6 mmHg on 1.95±1.13 antiglaucoma medications. Only 1 patient had hypotony following supramid removal, this resolved spontaneously within 1 month. Mean IOP of 13.8±4.16mmHg was achieved in patients who completed 3-year follow-up.

Conclusions:

Our results show good IOP and medication reduction at 3 years following BVT surgery, a procedure that plays a strong role in managing refractory glaucoma. Supramid removal can be considered a safe intervention. the IOP at 12 months following suture removal may represent a good outcome predictor for 3-year IOP.

Financial Disclosure:

None