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Ophthalmic Images |

Glaucoma Tube Changes After Suture Lysis Assessed by High-Resolution Anterior Segment Optical Coherence Tomography Online Only

Tadamichi Akagi, MD, PhD1; Akihito Uji, MD1; Nagahisa Yoshimura, MD1
[+] Author Affiliations
1Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
JAMA Ophthalmol. 2016;134(2):e153674. doi:10.1001/jamaophthalmol.2015.3674.
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This Ophthalmic Image shows swept-source optical coherence tomography of glaucoma tube changes after Baerveldt glaucoma implant into the ciliary sulcus.

A woman developed Takayasu disease and neovascular glaucoma in her early 20s. She underwent cardiovascular bypass surgery, but lost vision in her left eye. When another cardiovascular bypass was planned in her mid-40s, 95% of her right eye angle was closed, but her intraocular pressure (IOP) did not exceed the high teens while receiving glaucoma medications, probably because of reduced ocular circulation.1 In preparation for the IOP increase with circulation improvement, we performed a Baerveldt glaucoma implant into the ciliary sulcus with tube ligation with a 9-0 nylon suture, which was covered with a clear corneal graft.2,3 When the IOP increased to 25 mm Hg OD after cardiovascular surgery (Figure, A), laser suture lysis was performed and her IOP decreased to 6 mm Hg. One year after glaucoma implant surgery, her right eye IOP was in the mid-teens without medication (Figure, B).

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Averaged images of swept-source optical coherence tomography after Baerveldt glaucoma implant into the ciliary sulcus. A, A Ligated portion was clearly identified and debris-like materials were present at the distal side of the ligation before laser suture lysis. B, Tube expanded and debris-like materials disappeared after laser suture lysis.

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