Name of the Procedure:

Aqueous Shunt to Extraocular Equatorial Plate Reservoir, External Approach; with Graft

Summary

This surgical procedure involves placing a small tube (shunt) in the eye to help drain excess fluid, reducing eye pressure. The shunt directs the fluid to a small reservoir placed outside the eyeball, which then absorbs the fluid into surrounding tissues. A graft is used to support the placement of the shunt.

Purpose

This procedure is primarily used to manage glaucoma, a condition characterized by increased pressure in the eye that can lead to vision loss. The goal is to lower intraocular pressure to preserve the patient's vision and prevent further damage to the optic nerve.

Indications

• Uncontrolled intraocular pressure despite maximum medical therapy
• Advanced glaucoma
• Patients who are not good candidates for other types of glaucoma surgery

Preparation

• Patients may be advised to stop certain medications, such as blood thinners, before the procedure.
• Fasting might be required for several hours prior to surgery.
• Preoperative testing might include blood work, eye pressure measurements, and a detailed ophthalmic exam.

Procedure Description

1. Anesthesia: Typically, local anesthesia with sedation or general anesthesia is administered.
2. Incision: A small incision is made in the outer part of the eye.
3. Shunt Placement: The shunt is inserted and directed to the reservoir, which is positioned at the outer equatorial region of the eye.
4. Graft: A graft (sometimes taken from donor tissue or a synthetic material) is used to cover and support the shunt.
5. Closure: The surgical site is closed with sutures.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This procedure is performed in a hospital or an outpatient surgical center.

Personnel

• Ophthalmic surgeon
• Anesthesiologist
• Operating room nurses and surgical technicians

Risks and Complications

• Infection
• Bleeding
• Shunt failure or blockage
• Eye discomfort or pain
• Double vision or other visual disturbances
• Rarely, loss of vision

Benefits

• Significant reduction in intraocular pressure
• Prevention of further optic nerve damage
• Preservation of existing vision
• Benefits can typically be realized within a few weeks after surgery

Recovery

• Patients may need to wear an eye patch for a day or more.
• Use of prescribed eye drops to prevent infection and inflammation.
• Follow-up appointments are necessary to monitor eye pressure and ensure proper healing.
• Physical activity may be restricted for a few weeks post-surgery.

Alternatives

• Medicated eye drops
• Laser therapy (e.g., Trabeculoplasty)
• Other surgical options (e.g., Trabeculectomy) Each alternative has its pros and cons related to effectiveness, invasiveness, and recovery time.

Patient Experience

• During the procedure, patients will be sedated and should not feel pain.
• Post-procedure, some discomfort and redness are common.
• Pain is usually manageable with prescribed medications.
• Patients may experience a temporary blurred vision as the eye heals.