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 73
- Downloads 0
Laser-Assisted Opening of Gold Micro Shunt’s Windows in Glaucoma: Efficacy and Safety
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...
To Study the Role of Conservative Management and to Evaluate Effectiveness of Syringing and Probing in Children with Congenital Nasolacrimal Duct Obstruction in a Tertiary Care Institution of Kashmir
The study aimed to find the role of conservative management and to evaluate effectiveness of syringing and probing in children with congenital nasolacrimal duct obstruction in a tertiary care institution of Kashmir. The...
To Assess the Effect of Lighting on Identifying the Ishihara Colour Vision Plates in Trichromats
Aims: The main aim of present study is to investigate the effect of luminance on identifying the Ishihara colour vision plates in normal trichromats. Place and Duration of Study: Dr. Rishi Bhardwaj Visual Psychophysics l...
Parinaud Syndrome in Association with Thalamic Infarct in a Young Person
Aim: We report a case of Parinaud syndrome secondary to an acute left posteromedial thalamic infarct in a young person. Presentation of Case: Patient's main presenting complaints were blurring of vision and diplopia. The...
Primary Angle Closure as a Presenting Feature of Retinitis Pigmentosa: A Rare Case Report
Primary angle closure is an acute medical emergency. There are various predisposing factors in primary angle closure glaucoma such as age > 60 years, female gender, Eastern and Indian Asian race, positive family history,...