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Tube shunt surgery
Glaucoma
Key Points
- •The TVT study showed equivalent 5-year IOP control between Baerveldt tube shunt and trabeculectomy + MMC, but tube shunts had fewer re-operations (9% vs 29%).
- •The ABC trial demonstrated Baerveldt 350 achieves lower long-term IOP than Ahmed FP7 (13.2 vs 15.8 mmHg at 5 years), but Ahmed provides immediate flow and less early hypotony.
- •Corneal endothelial decompensation is the most significant long-term complication of tube shunts - progressive cell loss occurs at 4–6% per year.
- •Non-valved devices (Baerveldt, Molteno) require temporary tube ligation with 7-0 vicryl to prevent early hypotony; the suture dissolves at 4–6 weeks when the capsule matures.
- •Tube shunts are preferred over trabeculectomy in neovascular glaucoma, uveitic glaucoma, prior failed filtration, and extensive conjunctival scarring.
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- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations