Baerveldt Drainage Tube Motility in the Anterior Chamber

Tan, Annelie N; Witte, Pauline M. de; Webers, Carroll A.B.; Berendschot, Tos T. J. M.; Brabander, John de; Schouten, Jan S. A. G.; Beckers, Henny J. M.

doi:10.5301/ejo.5000379

Cited by 15 publications

(7 citation statements)

References 18 publications

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“…In a previous study by the same authors, it was demonstrated that the BV GDD tube remains in a stable position after transiridial placement, whereas the tube moves closer to the endothelium after placement ‘free’ into the AC (Tan et al. 2014). The more stable position of the tube after transiridial placement may explain the lower EC loss in this subgroup.…”

Section: Discussionmentioning

confidence: 99%

Corneal endothelial cell loss after Baerveldt glaucoma drainage device implantation in the anterior chamber

Tan

Webers

Berendschot

et al. 2016

Acta Ophthalmologica

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PurposeTo investigate central and peripheral corneal endothelial cell density (ECD) in relation to Baerveldt (BV) glaucoma drainage device (GDD) tube corneal (TC) distance.MethodsProspective study of all patients scheduled for glaucoma tube surgery with 36 months follow‐up. A BV GDD was inserted into the anterior chamber (AC). Anterior segment optical coherence tomography (AS‐OCT) scans were made to determine the TC distance. Central and peripheral ECD was measured, preoperatively and at 3, 6, 12, 24 and 36 months postoperatively.ResultsFifty‐three eyes were included [primary open‐angle glaucoma, (n = 13); secondary glaucoma, (n = 30); and primary angle‐closure glaucoma, (n = 10)]. Central ECD significantly decreased during follow‐up, with a mean decrease of 4.54% per year (p < 0.001), and 6.57% in the peripheral quadrant closest to the BV GDD tube (PQC, p < 0.001). In the PQC, a yearly decrease of 1.57% was shown after transiridial tube placement versus 7.43% after placement ‘free’ into the AC (p = 0.006). Endothelial cell (EC) loss was related to TC distance (mean 1.69 mm), with a central loss of 6.20% and 7.25% in the PQC per year with shorter TC distances, versus a central loss of 4.11% and 5.77% in the PQC per year with longer TC distances (outside mean ± 2SD, p < 0.001). A difference in EC loss by glaucoma subtype was not identified.ConclusionThe TC distance is of significant influence on corneal ECD, a shorter TC distance causing more severe EC loss, especially in the PQC. Transiridial placement of the BV GDD tube seems safer than placement ‘free’ into the AC.

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Section: Discussionmentioning

confidence: 99%

Corneal endothelial cell loss after Baerveldt glaucoma drainage device implantation in the anterior chamber

Tan

Webers

Berendschot

et al. 2016

Acta Ophthalmologica

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“…Several tubes (especially in more narrow anterior chambers) were placed transiridially through a peripheral iridectomy to secure a stable position and to prevent corneal endothelial cell loss (Tan et al. , ). In three cases, a pars plana approach was chosen.…”

Section: Methodsmentioning

confidence: 99%

Outcomes of severe uveitic glaucoma treated with Baerveldt implant: can blindness be prevented?

Tan

Cornelissen

Webers

et al. 2017

Acta Ophthalmologica

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The BGI is an effective and safe treatment for patients with refractive secondary glaucoma due to uveitis. In a majority of patients, VA remains stable and a low and stable IOP is maintained over time with an acceptable number of complications. In particular, patients with viral uveitis and glaucoma should be closely monitored for IOP peaks that may occur during episodes of a flare-up of uveitis, whereas at the other end of the spectrum, patients with JIA seem much more prone to hypotony maculopathy.

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“…Park et al [19] serially visualized AGV tube parameters using AS-OCT in 48 eyes over 12 months and found that tubes tended to shorten and migrate anteriorly, especially in eyes with a prior penetrating keratoplasty. Similarly, Tan et al [20] also reported progressive anterior tube movement of Baerveldt drainage implants in a group where the tube was inserted freely in the anterior chamber. However, the effect of head tilt on the position or length of the AGV tube has not been explored yet.…”

Section: Discussionmentioning

confidence: 79%

“…In the present study, we found that the intracameral position and length of the AGV tube may show some changes, albeit small, with mild alterations according to the head position in patients with glaucoma. Previously, a few studies have shown movement or migration of the intracameral tube of the GDDs [18][19][20]. In their case series, Law et al [18] reported three eyes with AGV that had 3 to 4 mm of tube movement in the anterior chamber at different gazes.…”

Section: Discussionmentioning

confidence: 99%

Effect of Head Position and Tube Entry on Corneal Endothelial Cells in Patients with Glaucoma Drainage Implants: A Cross-sectional Study

Han

Yoo

Park

et al. 2020

Korean J Ophthalmol

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Currently, reduction of intraocular pressure (IOP) is the only proven treatment for glaucoma [1]. IOP reduction can be achieved with medication, laser, or surgery. Surgical treatment for glaucoma includes trabeculectomy, glaucoma drainage device (GDD) implantation, trabecular bypass stents, ab interno trabeculectomy, and subconjunctival stenting [2-6]. The emergence of minimally invasive glaucoma surgery has broadened the scope of surgical alterna-Purpose: To investigate the effect of head tilt on the tube position of the Ahmed glaucoma valve (AGV) implanted in patients with glaucoma and to assess how the head tilt-induced alterations of tube parameters and the level of tube entry influence corneal endothelial cell density (ECD). Methods: A total of 29 eyes of 26 patients with AGV implantation were included. Tube-cornea distance, tube-cornea angle, and intracameral tube length were measured using anterior segment optical coherence tomography in three different head positions (neutral, 30° temporalward tilt, and 30° nasalward tilt). The tube entry was assessed using static gonioscopy. ECD was measured using specular microscopy before and after surgery. Results: The mean tube-cornea distance, tube-cornea angle, and intracameral tube length (neutral: 0.87 ± 0.39 mm, 30.56 ± 5.89˚, and 3.10 ± 0.82 mm, respectively) decreased with head tilts (temporalward: 0.82 ± 0.39 mm, 29.27 ± 5.82˚, and 3.04 ± 0.82 mm, respectively; nasalward: 0.83 ± 0.40 mm, 29.61 ± 6.04˚, and 3.05 ± 0.81 mm, respectively; all p < 0.01). The multivariate analyses found age and the tube insertion level to be associated with postoperative changes in the central ECD (p = 0.039 and 0.013, respectively), and the postoperative follow-up period and tube insertion level to be associated with the difference between the inferonasal and superotemporal ECDs (p = 0.034 and 0.007, respectively). Conclusions: Mild alterations of head positions induced changes in the intracameral tube positions of AGV implants; nevertheless, it did not significantly affect ECD loss. However, the eyes with tubes inserted anteriorly to Schwalbe's line may be more susceptible to corneal ECD loss.

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Baerveldt Drainage Tube Motility in the Anterior Chamber

Cited by 15 publications

References 18 publications

Corneal endothelial cell loss after Baerveldt glaucoma drainage device implantation in the anterior chamber

Corneal endothelial cell loss after Baerveldt glaucoma drainage device implantation in the anterior chamber

Outcomes of severe uveitic glaucoma treated with Baerveldt implant: can blindness be prevented?

Effect of Head Position and Tube Entry on Corneal Endothelial Cells in Patients with Glaucoma Drainage Implants: A Cross-sectional Study

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