Clinical Results of Modified Anterior Chamber Tube Shunt to an Encircling Band Surgery for Uncontrolled Intraocular Pressure

Abstract

Purpose 

To evaluate the clinical outcome of a modified anterior chamber tube shunt to an encircling band (ACTSEB) procedure in eyes with uncontrolled intraocular pressure (IOP) after scleral encircling band (EB) implantation for treatment of retinal detachment.

Methods 

Eight eyes of 7 consecutive patients were analyzed. Silicone tube (external/internal diameter, 0.64/0.30 mm) with 3 to 4 side ports around the distal portion was prepared. Temporary partial ligation of the tube was performed. The fibrous capsule around the EB was incised and the distal portion of each tube was placed under the EB and anchored to the sclera. The proximal part of the tube was inserted into the anterior chamber. IOP, use of antiglaucoma medication, and complications were recorded for 1 year after surgery. Success was defined as an IOP of 8 to 21 mm Hg and no requirement for an additional procedure; complete success was defined as control of IOP without use of antiglaucoma medication; and qualified success as control of IOP with the use of medication.

Results 

Mean preoperative IOP was 40.1 mm Hg under maximum tolerated medical therapy. Mean IOP was 10.6 mm Hg at 1 day and 16.9 mm Hg at 1 year after surgery. Antiglaucoma medication was used in 3 eyes during follow-up. Tube exposure was detected in 1 eye at 10 months after surgery. The complete success rate was 50% (4 eyes) and the qualified success rate 37.5% (3 eyes).

Conclusion 

Our modification of the ACTSEB procedure resulted in good clinical outcomes, with favorable control of IOP and a low rate of complications.