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Vitrectomy for pars plana placement of a glaucoma seton
W E Smiddy1, P E Rubsamen, A Grajewski
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Fla.
Ophthalmic Surgery
|August 1, 1994
Summary
Pars plana glaucoma seton implants offer a viable alternative for refractory glaucoma when standard procedures fail. This approach effectively lowered intraocular pressure (IOP) in most patients with severe anterior chamber issues.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Ophthalmic Implants
Background:
- Trabeculectomy has limited success in managing intraocular pressure (IOP) for specific glaucoma types.
- Severe anterior-chamber-angle disease presents unique challenges for IOP control.
Purpose of the Study:
- To evaluate the efficacy of pars plana glaucoma seton implants in refractory glaucoma cases.
- To assess an alternative surgical approach when standard glaucoma surgery is not feasible.
Main Methods:
- Ten patients with advanced, non-neovascular glaucoma underwent vitrectomy and pars plana seton implant placement.
- Tube placement via pars plana sclerotomy was used due to anatomical limitations in the anterior chamber.
Main Results:
- Nine out of ten patients achieved a postoperative IOP of 19 mm Hg or less without medication.
- The glaucoma seton implants were functional in all cases.
- Vision remained stable or improved in seven patients; three experienced deterioration due to complications.
Conclusions:
- Pars plana placement of glaucoma seton implants is a suitable alternative for refractory glaucoma.
- This technique is particularly beneficial in eyes with severely disrupted anterior chamber anatomy.