Commentary, Biomater Med Appl Vol: 7 Issue: 2

Glaucoma Shunts: Advancing Treatment Options for Intraocular Pressure Management

Jame Qiu^*

¹Department of Ophthalmology and Visual Science, University of Chicago, Chicago, USA

*Corresponding Author: Jame Qiu,
Department of Ophthalmology and Visual Science, University of Chicago, Chicago, USA
E-mail: jameqiu@gmail.com

Received date: 29 May, 2023, Manuscript No. BMA-23-106866;

Editor assigned date: 31 May, 2023, PreQC No. BMA-23-106866(PQ);

Reviewed date: 14 June, 2023, QC No. BMA-23-106866;

Revised date: 21 June, 2023, Manuscript No. BMA-23-106866 (R);

Published date: 28 June, 2023 DOI: 10.35248/2577-0268.100523

Citation: Qiu J (2023) Glaucoma Shunts: Advancing Treatment Options for Intraocular Pressure Management. Biomater Med Appl 7:2.

Abstract

Description

Glaucoma is a progressive eye disease characterized by the damage to the optic nerve, often caused by elevated Intraocular Pressure (IOP). If left untreated, glaucoma can lead to irreversible vision loss. While various treatment modalities exist, glaucoma shunts have emerged as effective tools in managing IOP and preserving vision. Glaucoma shunts, also known as implants, are small devices inserted into the eye to facilitate the excess aqueous humor and regulate IOP. These devices bypass the natural drainage pathway of the eye, known as the trabecular meshwork, to produce an alternate outflow pathway. By improving the flow of aqueous humor, glaucoma shunts help reduce IOP and mitigate the risk of optic nerve damage.

Types of glaucoma shunts

Ahmed Glaucoma Valve (AGV): The AGV is a widely used glaucoma shunt that consists of a small silicone tube connected to a reservoir. The reservoir regulates the drainage of aqueous humor from the eye, while the tube is inserted into the anterior chamber or pars plana, depending on the surgeon's preference. The AGV includes a valve mechanism to control the outflow of fluid and maintain a stable IOP.

Baerveldt glaucoma implant: The Baerveldt implant is a nonvalved glaucoma shunt that uses a larger silicone tube to regulate the drainage of aqueous humor. Unlike the AGV, the Baerveldt implant relies on the resistance of the tube and the plate to control the outflow of fluid. The plate is typically placed in the equatorial region of the eye, with the tube inserted into the anterior chamber.

Molteno implant: The Molteno implant is a non-valved glaucoma shunt that incorporates a silicone tube and a silicone plate. The tube is inserted into the anterior chamber, while the plate is positioned underneath the conjunctiva.

The Molteno implant allows for the drainage of aqueous humor, providing IOP control.

Anesthesia: Local anesthesia is administered to ensure patient comfort during the procedure. Some cases may require general anesthesia, depending on the patient's medical condition and preferences.

Conjunctival incision: An incision is made in the conjunctiva, a thin membrane covering the white part of the eye, to expose the surgical site.

Placement of the plate: The plate or reservoir of the glaucoma shunt is secured in a desired location, usually in the superotemporal or inferotemporal quadrant of the eye, and sutured to the sclera, the white outer wall of the eye.

Tube insertion: The tube of the glaucoma shunt is inserted into the anterior chamber or pars plana, ensuring that it is properly positioned to allow for the drainage of aqueous humor.

Closure: The conjunctiva is closed with sutures to complete the surgical procedure.

Infection: As with any surgical procedure, there is a risk of infection following glaucoma shunt surgery. Precautions are taken to minimize this risk, including proper sterilization techniques and the use of antibiotics.

Tube obstruction: The glaucoma shunt tube may become occluded or blocked over time, leading to inadequate drainage of aqueous humor. Regular follow-up visits with the ophthalmologist are necessary to monitor the function of the shunt and address any potential complications.