Laser-Assisted Opening of Gold Micro Shunt’s Windows in Glaucoma: Efficacy and Safety
Journal Title: Ophthalmology Research: An International Journal - Year 2015, Vol 4, Issue 3
Abstract
Objective: To determine the intraocular pressure-lowering effect and safety of opening the Gold Micro Shunt Plus’ (GMS+) windows with a titanium-sapphire laser. Design: Retrospective case series. Participants: The charts of 5 patients were reviewed. Diagnoses included primary open-angle glaucoma (n=3), aphakic glaucoma (n=1) and neovascular glaucoma (n=1). There were 4 males and 1 female, aged between 56 and 81 (mean age 70±11). They had undergone a mean of 2±1.6 surgeries (range: 0-4) before GMS implantation. Methods: IOP and number of glaucoma medications were recorded before and after the implantation of the GMS in 5 patients, as well as before and after the opening of the GMS’ windows with a titanium-sapphire (Ti-Sap) laser. Patients were assessed for complications arising from implanting the GMS and opening its windows. Follow-up lasted 17 to 42 months. Results: The GMS+ had 8 closed windows and one open flow port upon implantation. Four of these windows were opened in all five patients. Mean IOP before GMS implantation was 29.9±8.5 mmHg and it was 18.6±6.5 mmHg after implantation. Hence, implantation of the GMS was associated with an average decrease in IOP of 11.3±4.2 mmHg or 37.0% (p=0.076). The mean IOP before window-opening was 24.9±5.8 mmHg and after window opening, it was 17.6±5.7 mmHg. The IOP thus dropped 7.3±4.6 mmHg or 29.3% (p=0.055) on average after opening the GMS’ windows. The windows were opened an average 6.4±4.5 months after GMS implantation. IOP at follow-ups remained lower than pre-GMS levels in all patients. The IOP reduction post window opening lasted throughout follow-up, i.e. from 17 to 42 months (average 30±10 months). The number of glaucoma drops for each patient did not decrease after opening the GMS’ windows. One patient developed transitory cystoid macular edema after GMS implantation that resolved with a course of NSAID drops. No complications arose from the opening of the GMS’ windows. Conclusions: In our small case series, opening the GMS’ windows was safe and was associated with a substantial and sustained reduction in IOP.
Authors and Affiliations
Nicolas Cadet, Paul Harasymowycz
Keywords
Related Articles
- EP ID EP338889
- DOI 10.9734/OR/2015/17902
- Views 84
- Downloads 0
Review of the Use of SWAP and FDT for the Early Detection of Visual Field Loss
Background: To review the literature reporting SWAP and FDT for the early detection of visual field loss in glaucoma. Methods: A review of literature published on Medline, Scopus and Web of Science between 1966 and prese...
Applications of Thin Films in Ophthalmology
Nanotechnology provides a revolutionary approach to therapeutic challenges. Drug delivery, gene therapy, novel diagnostic methods and tissue engineering rank among the main fields of current nanomedical research. Thin fi...
RTVue Optical Coherence Tomography as an Imaging Modality for Scleral Thickness
Purpose: To examine RTVue (Optovue, Inc) optical coherence tomography (OCT) as a method for measuring scleral thickness. Methods: A prospective, single-center study of eyes with a variety of ocular diseases (no scleral d...
Barriers to Free Cataract Surgery in Yaoundé
Purpose: To identifying barriers to massive turnout for free cataract surgery campaigns in Yaoundé Methods: We prospectively interviewed 68 patients who radically refused free cataract surgery at the University Teaching...
Ocular Involvement in Patients with Rheumatoid Arthritis
Aim: The aim of this study was to find out the prevalence of various ocular involvements in patients with rheumatoid arthritis and to asssess the relation to immunological alterations. Methods: This is a cross-sectional...