@article{TEXTUAL,
      recid = {10080},
      author = {Kim, Inae J. and Wang, Jessie and Qiu, Mary},
      title = {Same-quadrant Baerveldt Glaucoma Implant-250 to Baerveldt  Glaucoma Implant-350 exchange},
      journal = {American Journal of Ophthalmology Case Reports},
      address = {2023-12-07},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Purpose: In eyes with a prior failed aqueous shunt (or  “tube”) requiring additional intraocular pressure (IOP)  control, options include angle surgery, cyclodestruction,  second tube, tube revision, or tube exchange. We present a  case of a same-quadrant tube exchange of a Baerveldt-250  (BGI-250) to BGI-350.&lt;/p&gt; &lt;p&gt;Observations: The patient is a  71-year-old African American female with severe-stage  primary open angle glaucoma of both eyes, and this case  focuses on the right eye. This eye had prior cataract  surgery with iStent, prior BGI-250 in the anterior chamber  (AC), and prior iStent removal with gonioscopy assisted  transluminal trabeculotomy (GATT). The visual acuity (VA)  was 20/150, and the IOP was 26 mmHg on 3 IOP-lowering  medications. The prior superotemporal BGI-250 had its  “wings” on top of the superior and lateral rectus muscles  and its tube tip in the AC. The implant was removed in its  entirety including the superficial and deep layers of its  capsule. The new BGI-350 was stented with a 3-0  polypropylene ripcord, ligated with a 7-0 polyglactin  suture, and implanted with its wings under the rectus  muscles and the tube tip in the sulcus. For early  IOP-lowering prior to ligature dissolution, 2 needle stab  fenestrations and an additional 7-0 polyglactin wick was  used. The capsule from the prior BGI-250 was used as a  patch graft for the new BGI-350. The ligature dissolved at  postoperative week (POW) 6. By POW8, the IOP was 18 mmHg on  3 IOP-lowering medications and frequent topical steroid,  the AC was quiet, and the ripcord was removed. A slow  steroid taper finished at postoperative month (POM) 6. By  POM 12, the VA was still at baseline 20/150, and the IOP  was 14 mmHg on 3 IOP-lowering medications.&lt;/p&gt;  &lt;p&gt;Conclusions &amp; importance: Patients with a prior failed  tube requiring additional IOP-lowering can undergo a  same-quadrant tube exchange. BGI-350s may offer more  IOP-lowering than BGI-250s, but the IOP-lowering achieved  in this patient's case could be attributable to differences  in postoperative management in addition to endplate size;  longer follow-up is needed. A tube exchange offers the  opportunity to reposition the tube tip from the AC to the  sulcus and to use the prior tube's capsule as a patch graft  for the new tube.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/10080},
}