OutƒPow Facility in Tube Shunt Fenestration

JOURNAL TITLE: Journal of Current Glaucoma Practice

Author
1. Jessica Olayanju
2. Bahjat Qaqish
3. Teresa Borras
4. David Fleischman
ISSN
0974-0333
DOI
10.5005/jp-journals-10078-1234
Volume
12
Issue
3
Publishing Year
2018
Pages
6
Author Affiliations
    1. Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, USA
    1. Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, USA
    1. North Carolina Translational and Clinical Sciences Institute, University of North Carolina, Chapel Hill, North Carolina, USA
    1. Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  • Article keywords
    Aqueous shunt, Baerveldt, Fenestration, Venting slit

    Abstract

    Aim: Determination of the effect of varying fenestration technique, and simulated patch graft on outflow facility for Baerveldt tube. Materials and methods: Silicone tubing similar to Baerveldt implant (AMO, Santa Ana, CA) with different fenestrations techniques was connected to a digital manometer in a closed system with a fluid-filled syringe on a stand to adjust pressure. The venting slits included: (A) 4 piercings with 7–0 TG140-8 needle; (B) a 2-mm slit with a 15° blade; (C) 4 piercings with a 15° blade; (D) 9–0 Nylon on CS140-6 needle with suture stenting the fenestration. Results: For pressures of 10, 20, 30, 40 mm Hg in groups A to D, the average outflow facility (mL/min/mm Hg) were group A: 0.11, 0.20, 0.28, 0.40; group B: 0.30, 0.69, 0.98, 0.93; group C: 0.73, 0.80, 0.81, 0.88; group D: 0.58, 0.65, 0.80, 0.87. For external compression with 10 gram weights at pressures of 10, 20, 30, 40 mm Hg, outflow were group A: 0.0, 0.18, 0.20, 0.53; group B: 0.75, 0.70, 0.97, 1.21. Group C: 0.18, 0.03, 0.57, 0.04. Group D: 0.73, 0.90, 1.13, 0.91. Conclusion: Effectivity of venting slits in maintaining adequate IOP in the early postoperative period for non-valved glaucoma implant is variable, multifactorial and largely intraocular pressure (IOP) dependent. Clinical significance: This study explores methods of producing fenestration and the effects on outflow at different pressures in an attempt to determine which fenestration technique has more reproducible results that can be made applicable in clinical practice. This is also the first study to evaluate the effect of external pressures similar to scleral patch graft on the tube fenestrations.

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