COMMENTARY

Gold Micro Shunt Implantation in Glaucoma

Shuchi B. Patel, MD

Disclosures

November 08, 2013

In This Article

Retrospective Analysis of the Success and Safety of Gold Micro Shunt Implantation in Glaucoma

Hueber A, Roters S, Jordan JF, Konen W
BMC Ophthalmol. 2013;13:35

Study Summary

The new surgical procedures for glaucoma are classified as minimally invasive glaucoma surgeries. One minimally invasive procedure under investigation is a gold microshunt implanted into the supraciliary space. Hueber and colleagues retrospectively evaluated the success rate and adverse effects of implanting the Gold Micro Shunt Plus (GMS+) (SOLX Inc.; Waltham, Massachusetts) in patients with glaucoma.

This study, conducted at University of Cologne, Germany, included 1 eye from each of 31 patients with uncontrolled intraocular pressure (IOP) and diagnoses of severe glaucoma (including primary open-angle glaucoma, pseudoexfoliation glaucoma, pigmentary glaucoma, secondary glaucoma from uveitis, neovascular glaucoma, or silicone oil-induced and pseudophakic closed-angle glaucoma). All GMS+ implantations were performed by the same surgeon. The procedure involved creating a full-thickness scleral flap and then implanting the GMS+ device, which measured 68 μm in height and had either 9 or 19 microchannels.

The main outcome measure was surgical success or failure. Success was defined as IOP > 5 mm Hg and < 21 mm Hg, and at least a 20% reduction of IOP from baseline at a minimum of 6 months after GMS+ implantation. Failure was defined as:

IOP outside the success range on 1 visit at least 6 months after GMS+ implantation;

Serious complications (retinal detachment, endophthalmitis, suprachoroidal hemorrhage, low-grade inflammation, and newly developed rubeosis iridis) at any time; or

The need for additional glaucoma surgery (except GMS+ repositioning) at any time.

Thirty eyes (97%) met 1 of the criteria for failure. Within a mean of 7.3 ± 7.7 months, another surgery was performed because of elevated IOP in 24 of 31 eyes (77%) and because of adverse effects in 2 (6%) eyes. The remaining 4 eyes that met a criterion for failure had an IOP reduction of less than 20% with comparable medication. Six GMS+ devices were explanted: 2 because of IOP elevation, 2 as a result of rubeosis iridis, and 2 because of low-grade inflammation.

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