A Simplified Technique for Glaucoma Drainage Device Ciliary Sulcus Implantation

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Device Technology

Background:

• Glaucoma drainage devices (GDD) are crucial for managing refractory glaucoma.
• Traditional anterior chamber placement carries risks, especially in certain patient populations.
• A simplified ciliary sulcus (CS) placement technique may offer an alternative.

Purpose of the Study:

• To describe a simplified technique for ciliary sulcus (CS) placement of glaucoma drainage devices (GDD).
• To report long-term clinical outcomes of CS GDD placement in phakic and pseudophakic eyes.
• To evaluate the safety and efficacy of this simplified GDD implantation method.

Main Methods:

• Retrospective case series of 10 patients undergoing CS placement of GDD (PAUL or Baerveldt implants).
• A standardized technique using a 90-degree bent needle for controlled scleral tunnel creation was employed.
• Data collected included intraocular pressure (IOP), visual acuity, visual fields, medication count, and complications.

Main Results:

• Mean follow-up was 47.7 months.
• Mean IOP significantly decreased from 28.7 mmHg to 14.4 mmHg (p = 0.002).
• Median medication use decreased from three to 1.5 (p = 0.014), with stable visual acuity and fields.

Conclusions:

• Simplified CS GDD placement achieves durable IOP reduction and preserves visual function.
• The technique demonstrates an acceptable safety profile over long-term follow-up.
• This method is particularly useful for eyes at risk of corneal complications or lacking a suitable anterior chamber.