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Original article
Supraciliary shunt in refractory glaucoma
  1. Michele Figus1,
  2. Stefano Lazzeri1,
  3. Paolo Fogagnolo2,
  4. Michele Iester3,
  5. Paolo Martinelli1,
  6. Marco Nardi1
  1. 1Department of Neuroscience, Ophthalmology, University of Pisa, Pisa, Italy
  2. 2G.B. Bietti Foundation-IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
  3. 3Department of Neurological Sciences, Ophthalmology, Genetic, University of Genoa, Genoa, Italy
  1. Correspondence to Dr Michele Figus, Department of Neuroscience, Ophthalmology, University of Pisa, Via Paradisa, 2 - Edificio 30, Pisa 56100, Italy; figus{at}


Aims This study aimed to evaluate the efficacy of Gold Micro Shunt (GMS) for suprachoroidal drainage in patients with refractory glaucoma.

Methods This is a prospective uncontrolled case series study. Fifty-five eyes of 55 patients were included. Study eyes underwent GMS implantation in the supraciliary space. Follow-up visits were performed on day 1, week 1 and months 1, 3, 6, 12 and 24; patients underwent slit-lamp examination, Goldmann applanation tonometry, ultrasound biomicroscopy and gonioscopy.

Results Before inclusion, the eyes underwent an average (±SD) of 1.9±0.7 (range 1–5) previous glaucoma surgery procedures. Forty eyes were pseudophakic, 12 were phakic and 3 were aphakic. The mean baseline intraocular pressure was 30.8±8.8 mm Hg (range 22–58 mm Hg) despite maximal medical treatment. After 2 years of follow-up, qualified success was achieved in 37 eyes (67.3%) and complete success was achieved in 3 eyes (5.5%). In success group patients, mean intraocular pressure decreased from 27.6±6.9 at baseline to 13.7±2.98 mm Hg after 2 years of follow-up; the mean (±SD) number of medications was 1.4±0.7 in the postoperative phase, compared with a value of 2.5±0.9 in the preoperative phase. Mild side effects occurred in 21 patients, with mild or moderate postoperative hyphema being the most frequent one. Development of a thin membrane, obstructing the anterior holes, was the most important factor affecting the efficacy of this device; it was found to be present in 12 patients from the failure group (66.7% of failures).

Conclusion GMS achieved qualified success in about 67.3% of eyes with uncontrolled refractory glaucoma with a low rate of complications.

  • Glaucoma
  • imaging
  • immunology
  • inflammation
  • tears
  • psychophysics
  • field of vision
  • ocular surface
  • cornea
  • optic nerve
  • intraocular pressure
  • treatment medical

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  • Competing interests None declared.

  • Ethics approval Ethics approval was provided by the Ethics Committee of the University of Pisa.

  • Provenance and peer review Not commissioned; externally peer reviewed.