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LONG-TERM RESULTS OF COMBINED ENDOSCOPE-ASSISTED PARS PLANA VITRECTOMY AND GLAUCOMA TUBE SHUNT SURGERY

Tarantola, Ryan M MD*; Agarwal, Anita MD*; Lu, Pengcheng MS; Joos, Karen M MD, PhD*

doi: 10.1097/IAE.0b013e3181ea48d3
Original Study
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Purpose: To assess outcomes after endoscope-assisted pars plana vitrectomy with concurrent pars plana tube shunt placement.

Methods: Records of 18 adult patients (19 eyes) with uncontrolled chronic angle-closure glaucoma associated with corneal opacification or fibrosed pupils were retrospectively reviewed. All eyes underwent endoscope-assisted pars plana vitrectomy with Baerveldt tube shunt placement into the vitreous cavity between 1997 and 2005. Intraocular pressure reduction, glaucoma medication reduction, complications, and visual acuity were analyzed.

Results: Mean follow-up duration was 62 months (range, 10-106 months). Mean preoperative intraocular pressure was 31.3 ± 10.5 mmHg on 3.4 ± 1.0 glaucoma medications. Intraocular pressure was significantly reduced at each postoperative time point examined. In the 17 eyes without phthisis, intraocular pressure was significantly reduced at the final follow-up examination to a mean of 11.4 ± 2.9 mmHg (P < 0.0001) on 1.3 ± 1.2 medications (P < 0.0001). No complications occurred in 14 of 19 eyes. Postoperatively, best-attained visual acuity improved in 14 of 19 eyes, remained unchanged in 4 of 19 eyes, and was reduced in 1 of 19 eyes.

Conclusion: Combined endoscope-assisted pars plana vitrectomy with placement of a Baerveldt tube shunt into the vitreous cavity is a useful intervention in patients with uncontrolled chronic angle-closure glaucoma, media opacities, and limited surgical options.

Combined endoscope-assisted pars plana vitrectomy with placement of a Baerveldt tube shunt into the vitreous cavity is a useful intervention in patients with uncontrolled chronic angle-closure glaucoma, media opacities, and limited surgical options.

From the *Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee; and †Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.

Supported by the Joseph Ellis Family Glaucoma Research Fund, a NIH/NEI travel grant, and an unrestricted departmental grant from Research to Prevent Blindness, Inc, New York.

This material was presented in part as a paper at the American Society of Retina Specialists Annual Meeting, Maui, Hawaii, October 15, 2008.

None of the authors have any financial/conflicting interests to disclose.

Reprint requests: Karen M. Joos, MD, PhD, Vanderbilt Eye Institute, Vanderbilt University, 2311 Pierce Avenue, Nashville, TN 37232; e-mail: karen.joos@vanderbilt.edu

© The Ophthalmic Communications Society, Inc.