Action of cyclodialysis utilizing an implant studied by manometry in a human eye

Gills, Jr Jp; Paterson, Christopher A.; Paterson, M.E.

doi:10.1016/s0014-4835(67)80057-5

Cited by 10 publications

(1 citation statement)

References 7 publications

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“…Such a procedure allows free communication from the anterior chamber into the suprachoroidal space, artificially augmenting uveoscleral outflow. [4][5][6][7][8] However, this procedure has several limitations, including the risk of intra-and post-operative haemorrhage due to the vascular nature of the uveal tissue, prolonged irreversible hypotony, late IOP spike due to unexpected cleft closure and scarring of the artificially created cleft. An ab interno approach was equally ineffective, with 75% of patients requiring further surgical intervention after the initial cyclodialysis creation at 60 days post-operatively.…”

Section: Overview Of Issues In Glaucoma Surgerymentioning

confidence: 99%

The SOLX® Gold Shunt Device for Glaucoma

Tam¹,

Ahmed²

2009

European Ophthalmic Review

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Egress of aqueous humour out of the intraocular space occurs via two distinct pathways: conventional and uveoscleral. The conventional outflow pathway, which comprises the trabecular meshwork, Schlemm's canal and, ultimately, the intra-and episcleral venous plexus, has traditionally been thought to account for the majority of aqueous outflow. The uveoscleral outflow pathway, which comprises the interstitium of the ciliary body, the suprachoroidal space and, ultimately, egress through the scleral vasculature, has been reported to contribute anywhere from 20 to 54% of total aqueous humour egress in normal human eyes. 1,2 Elevated intraocular pressure (IOP) typically results from increased resistance or compromise in either or both outflow pathways. When IOP remains uncontrolled by maximally tolerated medical therapy combined with appropriately selected laser therapy in the setting of advancing glaucomatous optic neuropathy or visual field loss, surgical intervention becomes necessary. Traditionally, glaucoma surgery has consisted of subconjunctival filtration; however, there are significant limitations to such procedures. An alternative site for filtration is the suprachoroidal space, which is targeted by a new device, the gold shunt, and will be discussed here. Overview of Issues in Glaucoma SurgeryGlaucoma surgery has traditionally been dominated by subconjunctival filtration procedures such as trabeculectomy and seton device implantation, both of which lower IOP by providing a conduit for aqueous humour to The SOLX ® Gold ShuntThe SOLX ® gold shunt (SOLX Inc., Waltham, MA) is a 24-karat-gold implant 5.2mm long, 2.4mm wide anteriorly and 3.2mm wide posteriorly (see Figure 1). Elemental gold has been shown to have good biocompatibility and to be inert as a foreign body in the intraocular tissues. 16,17 Two models were studied: the GMS and GMS Plus. The GMS model is a 6.2mg, 60µ-thick structure concealing nine channels, each of which is 25µ wide and 44µ high, through which aqueous humour drains from the anterior aspect of the shunt (which is situated in the anterior chamber) to exit the posterior aspect, which is placed in the suprachoroidal space. The GMS Plus model weighs 9.2mg and has larger channels (68µ high). The shunt is designed to increase uveoscleral outflow from the anterior chamber into the suprachoroidal space through the channels. In some cases, aqueous may also flow around the shunt itself.

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Section: Overview Of Issues In Glaucoma Surgerymentioning

confidence: 99%