BACKGROUND: Surgical treatment of glaucoma is usually indicated when IOP cannot be lowered enough to prevent progression of the disease or when medication cannot be tolerated or compliance cannot be achieved.Risks associated with glaucoma surgery include cataract formation, shallow or flat anterior chamber, hypotony leading to hypotony maculopathy and choroidal detachment, infection, and permanent visual loss.Today, glaucoma surgery is usually done by a partial-thickness procedure (trabeculectomy) with adjunctive use of anti-metabolites to prevent scarring.When conventional filtering surgery is unsuccessful because of conjunctival scarring from prior surgery, a glaucoma drainage implant may be used.The tube acts as a shunt bringing aqueous from the anterior chamber to the subconjunctival space.Unfortunately, complications often occur with implants.We examined a patient who had been given a different type of tube shunt, which brought aqueous directly into the tear film.
CASE REPORT(S). A 63 yo black male patient with advanced glaucoma presented to our clinic complaining of pain in his OS.He reported having lost vision in his OD secondary to a "stroke" in 1996.His OS had suffered from a retinal detachment and CRVO.The Millipore Valve was inserted in 1998; prior to this he had undergone a failed trabeculectomy.The patient’s medical history is significant for asthma, COPD, HTN, osteoarthritis, and atypical chest pain.Pertinent ocular medicines include Trusopt, Betoptic, and Xalatan.Visual acuity was finger counting in the OD and NLP in the OS.Slit lamp exam was unremarkable OD.The OS had a Seidel sign at the site of the Valve, indicating that aqueous was being shunted from the anterior chamber to the tear film.The valve was visible in the anterior chamber.Further examination revealed a closed angle in the OS along with aniridia OS.IOP was 24 in the OD and 7 in the OS.
CONCLUSIONS. The Millipore Valve is an alternative glaucoma drainage device that attempts to provide a decrease in intraocular pressure without the complications of traditional implants.This poster will show by photograph and drawing, the appearance and function of the Valve and compare it to other glaucoma drainage implants.