Gold Micro Shunt Implantation in Glaucoma
Gold Micro Shunt Implantation in Glaucoma
Hueber A, Roters S, Jordan JF, Konen W
BMC Ophthalmol. 2013;13:35
The new surgical procedures for glaucoma are classified as minimally invasive glaucoma surgeries. One minimally invasive procedure under investigation is a gold microshunt implanted into the supraciliary space. Hueber and colleagues retrospectively evaluated the success rate and adverse effects of implanting the Gold Micro Shunt Plus (GMS+) (SOLX Inc.; Waltham, Massachusetts) in patients with glaucoma.
This study, conducted at University of Cologne, Germany, included 1 eye from each of 31 patients with uncontrolled intraocular pressure (IOP) and diagnoses of severe glaucoma (including primary open-angle glaucoma, pseudoexfoliation glaucoma, pigmentary glaucoma, secondary glaucoma from uveitis, neovascular glaucoma, or silicone oil-induced and pseudophakic closed-angle glaucoma). All GMS+ implantations were performed by the same surgeon. The procedure involved creating a full-thickness scleral flap and then implanting the GMS+ device, which measured 68 μm in height and had either 9 or 19 microchannels.
The main outcome measure was surgical success or failure. Success was defined as IOP > 5 mm Hg and < 21 mm Hg, and at least a 20% reduction of IOP from baseline at a minimum of 6 months after GMS+ implantation. Failure was defined as:
• IOP outside the success range on 1 visit at least 6 months after GMS+ implantation;
• Serious complications (retinal detachment, endophthalmitis, suprachoroidal hemorrhage, low-grade inflammation, and newly developed rubeosis iridis) at any time; or
• The need for additional glaucoma surgery (except GMS+ repositioning) at any time.
Thirty eyes (97%) met 1 of the criteria for failure. Within a mean of 7.3 ± 7.7 months, another surgery was performed because of elevated IOP in 24 of 31 eyes (77%) and because of adverse effects in 2 (6%) eyes. The remaining 4 eyes that met a criterion for failure had an IOP reduction of less than 20% with comparable medication. Six GMS+ devices were explanted: 2 because of IOP elevation, 2 as a result of rubeosis iridis, and 2 because of low-grade inflammation.
Retrospective Analysis of the Success and Safety of Gold Micro Shunt Implantation in Glaucoma
Hueber A, Roters S, Jordan JF, Konen W
BMC Ophthalmol. 2013;13:35
Study Summary
The new surgical procedures for glaucoma are classified as minimally invasive glaucoma surgeries. One minimally invasive procedure under investigation is a gold microshunt implanted into the supraciliary space. Hueber and colleagues retrospectively evaluated the success rate and adverse effects of implanting the Gold Micro Shunt Plus (GMS+) (SOLX Inc.; Waltham, Massachusetts) in patients with glaucoma.
This study, conducted at University of Cologne, Germany, included 1 eye from each of 31 patients with uncontrolled intraocular pressure (IOP) and diagnoses of severe glaucoma (including primary open-angle glaucoma, pseudoexfoliation glaucoma, pigmentary glaucoma, secondary glaucoma from uveitis, neovascular glaucoma, or silicone oil-induced and pseudophakic closed-angle glaucoma). All GMS+ implantations were performed by the same surgeon. The procedure involved creating a full-thickness scleral flap and then implanting the GMS+ device, which measured 68 μm in height and had either 9 or 19 microchannels.
The main outcome measure was surgical success or failure. Success was defined as IOP > 5 mm Hg and < 21 mm Hg, and at least a 20% reduction of IOP from baseline at a minimum of 6 months after GMS+ implantation. Failure was defined as:
• IOP outside the success range on 1 visit at least 6 months after GMS+ implantation;
• Serious complications (retinal detachment, endophthalmitis, suprachoroidal hemorrhage, low-grade inflammation, and newly developed rubeosis iridis) at any time; or
• The need for additional glaucoma surgery (except GMS+ repositioning) at any time.
Thirty eyes (97%) met 1 of the criteria for failure. Within a mean of 7.3 ± 7.7 months, another surgery was performed because of elevated IOP in 24 of 31 eyes (77%) and because of adverse effects in 2 (6%) eyes. The remaining 4 eyes that met a criterion for failure had an IOP reduction of less than 20% with comparable medication. Six GMS+ devices were explanted: 2 because of IOP elevation, 2 as a result of rubeosis iridis, and 2 because of low-grade inflammation.
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