Surgical management of hypotony owing to overfiltration in eyes receiving glaucoma drainage devices.
OBJECTIVE
To assess rates of surgical revision of glaucoma drainage devices (GDDs) from hypotony owing to overfiltration and its management.


METHODS
Retrospective case series.


METHODS
Demographic characteristics, type of GDD implanted, type of surgical revision, and outcomes were obtained from the charts of patients undergoing GDD implantation and > or = 1 subsequent GDD revision in 2002 to 2006. All surgical revisions performed owing to hypotony from overfiltration in the absence of a wound leak were identified.


RESULTS
Of 1292 eyes undergoing GDD implantation, 21 (1.6%) developed hypotony owing to overfiltration requiring surgical revision: 15 eyes of 488 (3.1%) with a Baerveldt implant and 6 of 804 (0.7%) with an Ahmed (P=0.002). When including primary and secondary revisions, 6 of 12 eyes (50%) treated by using polyglactin suture ligation were successful (did not require additional surgery) compared with 8 of 10 (80%) undergoing suture ligation using prolene.


CONCLUSIONS
Hypotony owing to overfiltration is an uncommon GDD-surgery complication. Understanding how to manage patients who develop this complication can improve patient outcomes.
Stein
Joshua D
JD
Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.
McCoy
Allison N
AN
Asrani
Sanjay
S
Herndon
Leon W
LW
Lee
Paul P
PP
McKinnon
Stuart J
SJ
Allingham
R Rand
RR
Challa
Pratap
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology* / Q000601:surgery*; D011098:Polyglactin 910; D011184:Postoperative Period; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013537:Sutures; D014792:Visual Acuity
D011098:Polyglactin 910