Indications and Contraindications
The indications and preoperative considerations for plate-based tube implants are similar to those for trabeculectomy. These implants were historically used in eyes that had failed multiple prior trabeculectomies, had active inflammation or neovascularization, or had severe conjunctival scarring. Over time, the indications for plate-based tube implants have expanded considerably. The Tube Versus Trabeculectomy Study (see Treatment Decisions and Data Sidebar) demonstrated superior success rates with tube shunt surgery in eyes with previous cataract surgery or trabeculectomy. The ongoing Primary Tube Versus Trabeculectomy Study is designed to evaluate outcomes of tube shunt surgery compared with trabeculectomy as the initial surgical intervention for eyes that failed medical therapy. These implants can cause corneal endothelial cell loss and corneal decompensation over time. Posterior placement of the tube may reduce the rate of corneal endothelial cell loss.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.