Posters

Effectiveness of intraluminal stent removal in Baerveldt tube surgery

Poster Details

First Author: R.Prajapati UK

Co Author(s):    L. Au                    

Abstract Details

Purpose:

The Baerveldt tube (BVT) is a glaucoma drainage device increasingly used in cases of refractory glaucoma and where previous filtration surgery has failed. The BVT is partially occluded with an intraluminal stent, usually either 3.0 Supramid or 4.0 Prolene, and removal of this stent is used to further control the intraocular pressure. The aim of this study is to evaluate the effectiveness of intraluminal stent removal on intraocular pressure (IOP) and medication reduction in patients with a BVT over a 12 month post-stent removal period.

Setting:

The Manchester Royal Eye Hospital

Methods:

This is a retrospective case series involving 52 eyes with a BVT, identified as having intraluminal stent removal between January 2015 and December 2016 at Manchester Royal Eye Hospital. Main outcome measures included measurement of IOP, number of anti-glaucoma medications, complications and need for further intervention.

Results:

52 eyes underwent intraluminal stent removal including 22 patients with Primary Open Angle Glaucoma and 19 cases of secondary glaucoma. 40 Patients had supramid removal and 12 had Prolene removal. Pre-stent removal, mean IOP was 21.4mmHg (± 8.2mmHg) and average number of glaucoma drops was 2.4 (±1.2). At 12 months, mean IOP was 15.3mmHg (± 3.6mmHg) and mean number of glaucoma drops was 1.8 (±1.4). At 12 months post-stent removal, there was a statistically significant reduction of 6.2mmHg of intraocularpressure (p<0.0005) and a 0.6 reduction in topical glaucoma therapy (p<0.05). 2 of 52 eyes underwent clinical hypotony requiring surgical intervention.

Conclusions:

Removal of the intraluminal stent leads to a sustained significant decrease in intraocular pressure and reduction in glaucoma medication over a 12 month follow up period. At 12 months, 59% achieved greater than 20% IOP drop with same or less medication post stent removal. There was no statistically significant reduction between the supramid and prolene subgroups. 

Financial Disclosure:

None