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What is new after 40 years of glaucoma implants
1Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, MD, USA. jfreedman50@hotmail.com
Journal of Glaucoma
|February 25, 2010
Summary
Glaucoma drainage devices have evolved over 40 years. Current tube implants are effective, comparable to trabeculectomy, with ongoing innovations in non-tube implant technology.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Device Technology
Background:
- The Molteno long tube implant, introduced 40 years ago, has undergone significant modifications.
- Aqueous humor contains proinflammatory substances affecting bleb wall thickness and potentially causing hypertensive phases post-implantation.
- Systemic anti-inflammatory medication and surgical techniques like supra-Tenon insertion may mitigate aqueous humor's effects.
Purpose of the Study:
- To review the evolution and current efficacy of glaucoma drainage devices.
- To compare the effectiveness of tube implantation with traditional glaucoma surgeries.
- To highlight advancements in newer non-tube implant technologies.
Main Methods:
- Review of historical development of glaucoma drainage implants.
- Analysis of recent studies comparing tube implants to trabeculectomy.
- Discussion of emerging non-tube implant devices.
Main Results:
- Tube implantation demonstrates comparable efficacy to trabeculectomy in specific patient populations (pseudophakic or failed filters).
- Modifications to implants and surgical techniques can influence outcomes.
- Newer devices like the Express shunt, gold micro shunt, and iStent are under investigation.
Conclusions:
- Glaucoma drainage implants have a long history of development and refinement.
- Tube implants remain a viable and effective surgical option for glaucoma management.
- Ongoing innovation is leading to the development of novel, potentially less invasive, glaucoma surgical devices.
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