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[Münster standard: modified Paul® implantation in a condition following Preserflo® MicroShunt implantation. Video
Viktoria C Brücher1, Julian A Zimmermann2, Jens J Storp2
1Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland. viktoria.bruecher@ukmuenster.de.
Objective Of Surgery:
The aim of this surgical technique is the modified placement of a Paul® implant (Fa. Advanced Ophthalmic Innovations, Singapur) in eyes after failure of Preserflo® MicroShunt (Fa. Santen, Osaka, Japan) implantation for the best possible adjustment of the intraocular pressure.
Indications:
The technique presented here is intended for patients suffering from more complex glaucomas, which were unsuccessfully previously treated with a Preserflo® Microshunt (Santen Inc.).
Surgical Technique:
The special feature of the Münster standard is the choice of the surgical field and the waiver of a further tunnel placement. The patients receive a Paul® implant in the same quadrant as the previously inserted Preserflo® MicroShunt implant (superior temporal). The latter is explanted after preparation of the conjunctiva and priming of the Paul® implant with a Prolene 6.0 suture and fixation of the plate. In order to carry out the implantation of the Paul® tube through the existing 25-gauge tunnel, the latter is dilated laterally with an iris spatula under positioning of the anterior chamber. A surgical video, which is available online, shows the surgical technique in detail. ADVANTAGES OF THE MüNSTER STANDARD: The superior temporal surgical access promises easier handling. The fact that there is no need for a new tunnel effectively saves surgery time and is expected to reduce endothelial cell loss as only one tube remains in place in comparison to two anterior chamber tubes.
