Long-term Follow-up of a Case of Gold Shunt Surgery for Refractory Silicone Oil–induced Glaucoma

Abstract

Purpose:To report the first case of gold shunt surgery for treatment of silicone oil–induced refractory glaucoma in a tertiary care academic center, with 5-year follow-up.Design:The study design is a case report.Participants:The participant was a patient who underwent gold shunt surgery.Methods:Institutional Research Ethics Board approval for the study was obtained. A diabetic patient was referred for refractory glaucoma with a history of proliferative diabetic retinal detachment, and surgery with silicone oil. She was uncontrolled on maximal medical therapy and following informed consent, gold shunt surgery was performed. Ocular outcomes and number of medications were reviewed over a 5-year period.Results:Following uncomplicated surgery, intraocular pressure was reduced from 41 to 14 mm Hg, and the number of medications was reduced from 4 to 1. Glaucomatous optic neuropathy remained stable.Conclusions:Gold shunt surgery in this challenging case of silicone oil refractory glaucoma provided long-term intraocular pressure control and reduced need for medication over a 5-year period.

Surgical Treatment in Silicone Oil-Associated Glaucoma

“…Supraciliary shunts, such as the Cypass, which is no longer in use, and the gold micro shunts are attractive options that have proved effective in single case reports in SO-associated glaucoma [61,62]. However, their use in this particular setting has not been well explored.…”

“…However, their use in this particular setting has not been well explored. Moreover, their use has been associated with endothelial cell loss and with fibrosis and encapsulation [62] and the consequences of potential migration of SO in the suprachoroidal space are unknown [61]. More studies are required to establish their efficacy and safety profile.…”