Long-term results of combined endoscope-assisted pars plana vitrectomy and glaucoma tube shunt surgery.

PURPOSE

To assess outcomes after endoscope-assisted pars plana vitrectomy with concurrent pars plana tube shunt placement.

METHODS

Records of 18 adult patients (19 eyes) with uncontrolled chronic angle-closure glaucoma associated with corneal opacification or fibrosed pupils were retrospectively reviewed. All eyes underwent endoscope-assisted pars plana vitrectomy with Baerveldt tube shunt placement into the vitreous cavity between 1997 and 2005. Intraocular pressure reduction, glaucoma medication reduction, complications, and visual acuity were analyzed.

RESULTS

Mean follow-up duration was 62 months (range, 10-106 months). Mean preoperative intraocular pressure was 31.3 ± 10.5 mmHg on 3.4 ± 1.0 glaucoma medications. Intraocular pressure was significantly reduced at each postoperative time point examined. In the 17 eyes without phthisis, intraocular pressure was significantly reduced at the final follow-up examination to a mean of 11.4 ± 2.9 mmHg (P < 0.0001) on 1.3 ± 1.2 medications (P < 0.0001). No complications occurred in 14 of 19 eyes. Postoperatively, best-attained visual acuity improved in 14 of 19 eyes, remained unchanged in 4 of 19 eyes, and was reduced in 1 of 19 eyes.

CONCLUSION

Combined endoscope-assisted pars plana vitrectomy with placement of a Baerveldt tube shunt into the vitreous cavity is a useful intervention in patients with uncontrolled chronic angle-closure glaucoma, media opacities, and limited surgical options.