目的:描述该技术,并证明在Baerveldt-350水性分流管腔内使用厚3-0Prolene拉索直到结扎缝线溶解后的实用性和结果。
方法:单中心,非受控,回顾性病例系列。
方法:50例青光眼患者的50只眼接受Baerveldt-350房水分流器与3-0Proleneripcord的放置。
方法:在2019年10月1日至2022年6月30日期间,由一名外科医生在一个学术中心进行Baerveldt-350房水分流术的成年患者的所有眼睛进行回顾性图表回顾。
结果:收集的数据包括患者的人口统计学和临床特征,术前和术后的临床数据,包括眼压和青光眼药物,结扎线缝线溶解的术后时间点,和3-0Prolene拉索移除的时间点,或者它们是否永久留在原地。
结果:总计,包括50例患者的50只眼;平均年龄为69.5岁,54.0%的患者为女性,92%的病人是黑人,66%的眼睛有原发性开角型青光眼。26/50(52%)眼自发结扎溶解后,在术后最快的时间内进行了拉绳摘除,19/50(38%)眼延迟摘除,和5/50(10%)的眼睛没有撕裂去除。没有低眼压相关并发症的病例(浅层AC,低张力黄斑病变,脉络膜积液,脉络膜上腔出血)在此亚组的眼睛中没有进行撕裂索摘除。
结论:我们的结果表明,常规使用3-0Prolene利索部分闭塞Baerveldt-350s管腔是一种安全有效的策略,可以最大程度地减少结扎缝线溶解时突然的低张力相关并发症。此策略可实现更可控的术后过程和安全的两步降低IOP(1:结扎线溶解时,和2:当拉索被移除时)。
OBJECTIVE: To describe the technique and demonstrate the utility and outcomes of using a thick 3-0 Prolene ripcord in the lumen of a
Baerveldt-350 aqueous shunt until after the ligature suture dissolves.
METHODS: Single-center, noncontrolled, retrospective case series.
METHODS: A total of 50 eyes from 50 patients with glaucoma undergoing placement of
Baerveldt-350 aqueous shunts with 3-0 Prolene ripcords.
METHODS: A retrospective chart review was performed for all eyes of adult patients that had undergone a
Baerveldt-350 aqueous shunt placement by a single surgeon at a single academic center between October 1, 2019 and June 30, 2022.
METHODS: Data collected included demographic and clinical characteristics of the patients, preoperative and postoperative clinical data including intraocular pressure (IOP) and glaucoma medications, postoperative timepoints of ligature suture dissolution, and timepoints of 3-0 Prolene ripcord removal or whether they were permanently left in place.
RESULTS: In total, 50 eyes from 50 patients were included; mean age was 69.5 years, 54.0% of patients were female, 92% of patients were Black, and 66% of eyes had primary open-angle glaucoma. Twenty-six of 50 (52%) eyes had ripcord removal at the soonest postoperative visit after spontaneous ligature dissolution, 19/50 (38%) eyes had delayed ripcord removal, and 5/50 (10%) eyes had no ripcord removal. There were no cases of hypotony-associated complications (shallow anterior chamber, hypotony maculopathy, choroidal effusion, suprachoroidal hemorrhage) in this subgroup of eyes that underwent no ripcord removal.
CONCLUSIONS: Our results demonstrate that routine use of a 3-0 Prolene ripcord to partially occlude the lumen of a
Baerveldt-350 is a useful strategy to minimize sudden hypotony-associated complications when the ligature suture dissolves. This strategy allows for a more controlled postoperative course and a safe 2-step decrease in IOP (1: when the ligature dissolves, and 2: when the ripcord is removed).
BACKGROUND: The author(s) have no proprietary or commercial interest in any materials discussed in this article.