Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Oct;120(10):1056-1059.
doi: 10.1007/s00347-023-01914-5. Epub 2023 Sep 18.

[Münster standard: modified Paul® implantation in a condition following Preserflo® MicroShunt implantation. Video article]

[Article in German]
Viktoria C Brücher  1 , Julian A Zimmermann  2 , Jens J Storp  2 , Nicole Eter  2
Affiliations
Review

[Münster standard: modified Paul® implantation in a condition following Preserflo® MicroShunt implantation. Video article]

[Article in German]
Viktoria C Brücher et al. Ophthalmologie. 2023 Oct.

Abstract
in English, German

Objective of surgery: The aim of this surgical technique is the modified placement of a Paul® implant (Fa. Advanced Ophthalmic Innovations, Singapur) in eyes after failure of Preserflo® MicroShunt (Fa. Santen, Osaka, Japan) implantation for the best possible adjustment of the intraocular pressure.

Indications: The technique presented here is intended for patients suffering from more complex glaucomas, which were unsuccessfully previously treated with a Preserflo® Microshunt (Santen Inc.).

Surgical technique: The special feature of the Münster standard is the choice of the surgical field and the waiver of a further tunnel placement. The patients receive a Paul® implant in the same quadrant as the previously inserted Preserflo® MicroShunt implant (superior temporal). The latter is explanted after preparation of the conjunctiva and priming of the Paul® implant with a Prolene 6.0 suture and fixation of the plate. In order to carry out the implantation of the Paul® tube through the existing 25-gauge tunnel, the latter is dilated laterally with an iris spatula under positioning of the anterior chamber. A surgical video, which is available online, shows the surgical technique in detail. ADVANTAGES OF THE MüNSTER STANDARD: The superior temporal surgical access promises easier handling. The fact that there is no need for a new tunnel effectively saves surgery time and is expected to reduce endothelial cell loss as only one tube remains in place in comparison to two anterior chamber tubes.

Zusammenfassung: OPERATIONSZIEL: Ziel dieser Operationstechnik ist die modifizierte Anlage eines PAUL®-Implantates (Fa. Advanced Ophthalmic Innovations, Singapur) in Augen nach PreserFlo® MicroShunt(Fa. Santen, Osaka, Japan)-Implantatversagen zur bestmöglichen Augeninnendruckeinstellung.

Indikationen: Die Operationsindikation bezieht sich auf komplexere Glaukome, die bereits erfolglos mittels PreserFlo® MicroShunt operiert wurden.

Operationstechnik: Die Besonderheiten des Münsteraner Standards sind die Wahl des Operationsgebietes und der Verzicht auf eine weitere Tunnelneuanlage. Die Patienten erhalten eine PAUL®-Implantation im selben Quadranten der zuvor erfolgten PreserFlo® MicroShunt-Implantation (superior-temporal). Nach Präparation der Bindehaut, Priming des PAUL®-Implantates mittels Prolene‑6.0‑Faden und Fixierung der Platte erfolgt die Explantation des PreserFlo® MicroShunt. Um die Implantation des PAUL®-Schlauchs durch den alten 25-Gauge-Tunnel zu vollziehen, wird dieser mittels Irisspatel unter Vorderkammerstellung seitlich dilatiert. Anhand eines Operationsvideos, das online zur Verfügung steht, wird die Operationstechnik detailliert dargestellt. VORTEILE DES MüNSTERANER STANDARDS: Der operative Zugang temporal-superior verspricht ein leichteres Handling, der Verzicht auf eine Tunnelneuanlage spart effektive Operationszeit. Weniger Endothelzellverluste bei nur einem liegenden Schlauch im Vergleich zu 2 Vorderkammerschläuchen sind potenziell zu erwarten.

Keywords: Glaucoma drainage implant; Implant failure; Intraocular pressure; Surgical indications; Surgical technique.

PubMed Disclaimer

References

Literatur

    1. Quigley HA, Broman AT (2006) The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 90(3):262–267 - DOI - PubMed - PMC
    1. Budenz DL, Barton K, Gedde SJ et al (2015) Five-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology 122(2):308–316 - DOI - PubMed
    1. Christakis PG, Zhang D, Budenz DL et al (2017) Five-year pooled data analysis of the Ahmed Baerveldt comparison study and the Ahmed versus Baerveldt study. Am J Ophthalmol 176:118–126 - DOI - PubMed
    1. Christakis PG, Kalenak JW, Tsai JC et al (2016) The Ahmed versus Baerveldt study: five-year treatment outcomes. Ophthalmology 123(10):2093–2102 - DOI - PubMed
    1. Gedde SJ, Schiffman JC, Feuer WJ et al (2012) Treatment outcomes in the Tube Versus Trabeculectomy (TVT) study after five years of follow-up. Am J Ophthalmol 153(5):789–803.e2 - DOI - PubMed - PMC

LinkOut - more resources