Juha Välimäki1. 1. Department of Ophthalmology, Central Hospital of Lahti, Lahti, Finland. juha.valimaki@phks.fi
Abstract
PURPOSE: To prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant (GDI) surgery. METHODS: A total of 42 eyes of 34 consecutive patients with refractory glaucoma requiring single-plate Molteno implantation were retrospectively reviewed. Peritubular filtration was checked intraoperatively in all filtered eyes. Fibrin glue was used over the scleral flap intraoperatively in every eye with peritubular leakage. All Molteno tubes were completely closed with an absorbable ligature. RESULTS: Peritubular filtration was detected in 11 eyes of 11 patients. All 11 eyes maintained intraocular pressure (IOP) >or= 16 mmHg in the immediate postoperative phase. The mean IOP on the first postoperative day was 30.5 +/- 10 mmHg. After an average follow-up of 6 months, the mean IOP in these 11 eyes was 19.1 +/- 6 mmHg. No complications or Seidel-positive aqueous leak were observed during the follow-up period. CONCLUSIONS: Results suggest that intraoperative use of fibrin glue is a viable option for reducing peritubular filtration and preventing immediate postoperative hypotony after GDI surgery.
PURPOSE: To prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant (GDI) surgery. METHODS: A total of 42 eyes of 34 consecutive patients with refractory glaucoma requiring single-plate Molteno implantation were retrospectively reviewed. Peritubular filtration was checked intraoperatively in all filtered eyes. Fibrin glue was used over the scleral flap intraoperatively in every eye with peritubular leakage. All Molteno tubes were completely closed with an absorbable ligature. RESULTS: Peritubular filtration was detected in 11 eyes of 11 patients. All 11 eyes maintained intraocular pressure (IOP) >or= 16 mmHg in the immediate postoperative phase. The mean IOP on the first postoperative day was 30.5 +/- 10 mmHg. After an average follow-up of 6 months, the mean IOP in these 11 eyes was 19.1 +/- 6 mmHg. No complications or Seidel-positive aqueous leak were observed during the follow-up period. CONCLUSIONS: Results suggest that intraoperative use of fibrin glue is a viable option for reducing peritubular filtration and preventing immediate postoperative hypotony after GDI surgery.