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The Effect of Suture Wick Technique on Early Intraocular Pressure Control after Non-valved (Baerveldt 350) Glaucoma Drainage Device Surgery

Rothman, Adam L., MD*; An, Selena J., MSPH; Herndon, Leon W. Jr, MD*

doi: 10.1097/IJG.0000000000001080
Original Study: PDF Only

Purpose: To compare early post-operative outcomes of patients who underwent Baerveldt 350-mm2 aqueous drainage device (Abbott Medical Optics, Inc., Santa Ana, CA) implantation with and without 7-0 polyglactin (vicryl) suture placement through tube fenestration to serve as a stenting wick.

Methods: Patients were identified by a retrospective review of the electronic medical records of one attending surgeon’s Baerveldt implantation (LWH) conducted by searching the Current Procedural Terminology code “placement of aqueous shunt.” All patients had tube ligature with 7-0 vicryl suture and 6-0 prolene placed as a ripcord with four fenestrations. Thirty-seven patients had no vicryl wick while 38 patients had a stenting wick. Data were collected from the pre-operative visit, post-operative day one, post-operative week three, post-operative week five, and post-operative month two.

Results: While intraocular pressure (IOP) and number of medications were reduced at every follow-up visit, there was no significant difference in IOP, percent reduction of IOP, number of medications, and visual acuity between patients with and without vicryl wick at each time point. Both groups also had comparable morbidity with no significant difference in ripcord removal, incidence of complications, or need for additional surgery.

Conclusions: Baerveldt implantation with vicryl wick placement can safely lower IOP and medication burden but does not appear to offer additional utility to fenestration without vicryl wick.

*Duke University Department of Ophthalmology, Durham, NC, USA

Duke University School of Medicine, Durham, NC, USA

MEETING PRESENTATION: Presented in part at the American Glaucoma Society Annual Meeting, March 3, 2018.

FINANCIAL SUPPORT: Departmental.

CONFLICT OF INTEREST: None.

Reprints: Leon W. Herndon Jr, MD, Duke University Department of Ophthalmology, 2351 Erwin Rd, Box 3802, Durham, NC 27710

Received May 23, 2018

Accepted August 25, 2018

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