Today, however, the shift has been toward the use of tube shunts in less-refractory patients. The latter group includes eyes with neovascular glaucoma, uveitic glaucoma, iridocorneal endothelial syndrome, and epithelial and fibrous ingrowth these eyes have been managed with tube shunt surgery for decades. “That included eyes that already had a failed trabeculectomy, eyes with extensive conjunctival scarring from prior surgeries and eyes with certain refractory glaucomas that tend to do poorly with traditional filtering surgery. “Historically, tube shunts were reserved for eyes felt to be at high risk for failure with trabeculectomy,” he continues.
#Pulltube review series
“Also, a series of surveys of the American Glaucoma Society membership, starting back in 1996, has demonstrated that tube shunts are being selected as an alternative to trabeculectomy with increasing frequency. “Medicare claims data has shown a clear shift away from trabeculectomy and toward tube shunt surgery,” he points out. Gedde, MD, a professor of ophthalmology at Bascom Palmer Eye Institute in Miami, notes that the use of tube shunts for the surgical management of glaucoma has been growing in popularity. For many years trabeculectomy has been the most popular approach in this situation, but that’s slowly been changing. A lthough topical drops remain the first-line treatment for most new glaucoma patients, surgery is often necessary to manage patients in need of major intraocular pressure reduction.
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