New Technique of Anterior Chamber Tube Shunt to an Eneircling Band for Refractory Glaucoma

ABSTRACT

New techniques of anterior chamber tube shunt to an encircling band (ACTESB) were used in 49 eyes of 47 patients with neovascular glaucoma and other types of refractory glaucoma. In 34 eyes of 33 patients (Group A), by using Isingle slit incision and end suturing technique at the distal portion of tube, intraocular bressure was controlled less than 21mmHg in 21 eyes (61.8%) with a follow-up of 6 months to 18 months (mean, 13 month). The mean intraocular pressure of 36.38mmHg was reduced. Visual acuity was maintained or improved in 61 %. In 15 eyes of 14 patients (Group B), by using multiple slit incision at the distal portion of tube and single slit incision of the tube beneath scleral flap and external occlusion of tube with 8-0 vicry1, successful outcome was obtained in 86.6% of eyes after average follow up of 6 months. The mean intraocular pressure of 41.47mmHg reduced. Visual acuity was maintained or improved in 86.8%. The incidence of flat anterior chamber was decreased markedly and hyphema was not found in group B. In 4 eyes, there was evidence of blockage of the distal end of tude. Thus we think that the pattern of one piece valved implant is better than the other technique.