A novel releasable wick suture for early intraocular pressure control in Baerveldt tube surgery

Abstract

Background: Early post-operative intraocular pressure (IOP) control following Baerveldt tube (BVT) implant is critical, especially in cases with advanced glaucoma.

Aim: This study aimed to review the efficacy and safety of a releasable wick suture for early control of post-operative IOP in patients implanted with a 350 mm2 BVT.

Setting: This study is a retrospective chart review of all patients implanted with BVT and a releasable 9–0 Vicryl wick placement, performed under one surgeon.

Methods: Efficacy data of IOP and number of glaucoma medications were collected pre-operatively and on post-operative day 1 and weeks 1, 4, 6, 8 and 12. Safety, visual acuity and wick removal data were also collected.

Results: The utilisation of a releasable wick suture with BVT implantation gives early post-operative IOP control and fewer medications day 1 post-operatively. The IOP and number of medications significantly decreased at each time point while the visual acuity did not significantly change compared to the pre-operative level after 12 weeks in the total population. Mean IOP of patients with wick removal increased in hypotony cases and decreased in high pressure cases. There was no difference in terms of safety profile between cases with wick remaining and wick removal.

Conclusion: The use of a releasable wick suture with BVT implantation gives early IOP control with fewer glaucoma medications in the first three post-operative months and the option of suture removal when IOP is too high or low.

Contribution: The study introduced a novel method for early IOP control after BVT implant.