Refractory glaucoma surgical treatment with leucosapphire drainage device implantation
PURPOSE: To increase the efficiency of refractory glaucoma surgical treatment. METHODS: A retrospective study of 29 patients (29 eyes) with refractory glaucoma, who underwent the original leucosapphire drainage implantation («VIM», Saint-Petersburg). Most patients (25 eyes - 86.2%) had primary open-angle glaucoma and have been repeatedly operated previously. 2 patients (6.9%) had traumatic glaucoma, and 2 patients (6.9%) had neovascular glaucoma. The average IOP before surgery was 32.4±0.7 mm Hg. All IOP measurements were conducted by means of Maklakov tonometry with 10 g weights. Follow up period varied from 1 to 8 years. RESULTS: After the implantation of leucosapphire drainage, IOP level significantly decreased from 32.4±0.7 mm Hg to 14.8±1.0 mm Hg. In 1 month after drainage implantation mean IOP was 19.3±1.0 mm Hg, after 3 months it equaled 19.8±0.9 mm Hg, after 6 months - 20.0±0.9 mm Hg, one year after surgery - 20.5±0.9 mm Hg. IOP was below 26.0 in 89.6% cases, in 37.9% of which no additional medication had been administered. Compensation at the IOP level of <22.0 mm Hg was noted in 75.9% of cases. Visual field test was stable in 69.0% of patients. The following postoperative complications were registered in our study: a shallow anterior chamber (17.2%), hypertension episode (20.7%), hyphema (17.2%), ciliochoroidal detachment (17.2%), external filtration (10.3%), uveal reaction (6.9%). CONCLUSION: Leucosapphire drainage device implantation may be considered an alternative method of effective surgical treatment of patients with refractory forms of glaucoma.