Aqueous Shunt Exposure: A Retrospective Review of Repair Outcome

作者：Huddleston Stephen M; Feldman Robert M^*; Budenz Donald L; Bell Nicholas P; Lee David A; Chuang Alice Z; Mankiewicz Kimberly A; Koval Michael S; Elizabeth Truong; Moraczewski Alexei

来源：Journal of Glaucoma, 2013, 22(6): 433-438.

DOI：10.1097/IJG.0b013e3181f3e5b4

• aqueous shunts
• extrusion
• erosion
• exposure
• glaucoma drainage devices
• tube shunt

Purpose %26lt;br%26gt;To describe the patient outcomes and factors affecting those outcomes after aqueous shunt exposure repair. %26lt;br%26gt;Patients and Methods %26lt;br%26gt;Forty-three eyes from Robert Cizik Eye Clinic and Bascom Palmer Eye Institute from 1995 to 2007 suffered from aqueous shunt exposure and were repaired by participating surgeons. Thirty-three were tube exposures and 7 were plate exposures. The remaining 3 exposure classified complications included a patch graft exposure, an elbow exposure, and 1 unknown complication. Forty eyes were followed for evidence of additional aqueous shunt exposures or additional surgical interventions for 46.6 weeks (40.2 wk) (range: 3 to 168 wk). %26lt;br%26gt;Results %26lt;br%26gt;Seventeen of 40 eyes required additional surgical intervention: 15 (45%) from the tube exposure group and 2 (29%) from the plate exposure group. Five (13%) eyes needed eventual removal of the shunt. Black race, diabetes mellitus, a high number of glaucoma medications before shunt implantation, a history of multiple glaucoma laser procedures, and combination of an initial aqueous shunt implantation with another surgery were found to be associated with a worse outcome after exposure repair. %26lt;br%26gt;Conclusions %26lt;br%26gt;Intraocular pressure, number of medications, and visual acuity remained stable during follow-up after revision. Diabetes mellitus was associated with a shorter average time between initial repair and reintervention, and 4 other variables were associated with a higher likelihood of reintervention.

• 出版日期2013-8