Evaluation of Nd:YAG laser membranectomy in blocked tubes after glaucoma tube-shunt surgery

Am J Ophthalmol. 1997 Dec;124(6):781-6. doi: 10.1016/s0002-9394(14)71695-2.

Abstract

Purpose: To determine the effectiveness of Nd:YAG laser membranectomy for reopening blocked glaucoma tube shunts and maintaining the patency over time.

Methods: We reviewed retrospectively the records of 13 patients (13 eyes) who, during the period January 1990 through June 1996, underwent Nd:YAG laser membranectomy in an attempt to reopen a blocked glaucoma tube shunt. Intraocular pressure and tube patency were evaluated at each follow-up visit.

Results: Nd:YAG laser membranectomy effectively opened the blocked glaucoma tube shunts in 11 (84.6%) of 13 eyes. Two tubes could not be reopened. Reblockage occurred in seven eyes (53.8%) within the first 11 weeks; four tubes (30.8%) remained patent through follow-up periods of 39, 82, 106, and 169 weeks. Postlaser complications were moderate anterior chamber reaction in four eyes (30.8%), hyphema in two eyes (15.4%), corneal edema in two eyes (15.4%), pressure spike in one eye (7.7%), and shallow anterior chamber in one eye (7.7%).

Conclusions: Nd:YAG laser membranectomy is effective in reopening blocked glaucoma tube shunts but is associated with a relatively high rate of subsequent reblockage in the initially successful cases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / physiology
  • Iris / blood supply*
  • Laser Therapy / methods*
  • Male
  • Membranes / surgery
  • Middle Aged
  • Molteno Implants*
  • Neovascularization, Pathologic / etiology
  • Neovascularization, Pathologic / surgery*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Trabeculectomy / adverse effects*
  • Treatment Outcome