Long‐term outcome of supraciliary gold micro shunt in refractory glaucoma

Abstract

Purpose To evaluate the 10‐year follow‐up efficacy and safety of gold micro shunt (GMS) in patients with refractory glaucoma, and the potential risk factors for failure. Methods Retrospective data analyses based on medical records from 55 patients who underwent GMS implant for refractory glaucoma between March 2007 and April 2008. The primary outcome measure was the cumulative probability of success defined as intraocular pressure (IOP) below 21 mmHg together with a 33% lowering of the baseline IOP with (qualified) or without (complete) topical medications, no reoperation for glaucoma or loss of light perception. Results Mean IOP 10 years after the GMS implantation was 21.6 ± 5.1 mmHg with 2.7 ± 0.7 drugs. Qualified success was achieved in 8/55 patients (14.5%) with a mean of 2.9 ± 0.8 drugs at 5 years and in 2/55 patients (3.6%) with a mean of 2.7 ± 1.0 drugs at 10 years. None of the patients reached complete success at five years from surgery. The cumulative probability of complete success was 14%, 9% and 0% at 1, 2 and 5 years, respectively, and 72%, 67%, 36% and 3.6% at 1, 2, 5 and 10 years, respectively, for qualified success criterion. Baseline IOP for complete success, number of baseline medication for qualified success and age at the time of GMS implantation for both criteria were risk factors significantly associated with failure. Conclusion A very low long‐term survival rate of GMS in refractory glaucoma was found. Most patients did not reach the IOP success criteria of the study, even with the re‐introduction of medications, leading to the need for further surgical procedures.

Clinical Results of the MINIject Implant for Suprachoroidal Drainage

“…The Solx Gold Micro Shunt (SOLX, Waltham, MA, USA), another supraciliary/ suprachoroidal implant, showed promising early results while having a low long-term survival rate [13,17]. Membrane formation, which obstructed the drainage pathway out of the anterior chamber, was described to occur in a majority of failure cases [18].…”

Microfluidics in the eye: a review of glaucoma implants from an engineering perspective

“…204 There is also a 10-year follow-up study that reports the failure of the GMS in 96.4% patients even with proper medication use. 205 The high rate of failure is likely caused by the severe fibrotic reaction both surrounding and inside the shunt, and therefore the biocompatibility of the implant might need to be further improved. 39…”