1. Department of ophthalmology
Russian People’s Friendship University 1
Moscow, Russian Federation
Ophthalmic unit of Skhodnya city hospital 2,
Moskovskaya oblast.
Kumar V.1,2, Frolov M.A.1 , Isufaj E2.,Makovetskaya I.E.2
Long ter m results of stainless
steel wire micro-drainage device
(SSWMDD) in sur gical
management of refractor y primar y
open-angle glaucoma (RPOAG)
Innovative educational program of the university
Financial disclosure - none

2. Metallic shunts in glaucoma
surgery
 SOLX gold shunt,  Ex-PRESS mini
SOLX, Inc. glaucoma shunt,
Optonol Ltd.

3. Micro-drainage device made
from stainless steel wire

4. Purpose
To evaluate long term results of a new
filtering procedure using SSWMDD in
surgical management of RPOAG.
Setting
Department of ophthalmology,
Russian people’s friendship university,
Moscow
Ophthalmic unit of Skhodnya city
hospital, Himki, Moscovskaya oblast

5. Technique of SSWMDD preparation
SSWMDD was made from surgical grade stainless
steel wire by winding it once on a 2.5 mm wide and
0.5 mm thick metallic spatula. SSWMDD are
sterilized by autoclaving

7. Methods and material
Total 42 cases (42 eyes): male – 22 (52.4%); female – 20 (47.6%)
Patient’s age: avg. age: 68.6 +/-7.1 yrs. (55 - 79 yrs. )
Study period: April 2008 – December 2009
Exclusion criteria: minimum follow – up period 1 year
• Cases were admitted for evisceration for painful terminal
glaucoma
• Intraocular pressure (IOP) varied from 27 to 41 mmHg (as per
Maklakov’s method)
• All patients were instilling not less than 2 eye drops

8. Methods and material
Main outcome measures:
IOP change,
complication rate,
additional glaucoma medication,
need for surgical revision.
Criteria for success:
relief from pain,
normal outlook of the eye ball,
decrease in preoperative IOP by 30% or more
with or without glaucoma medication.

9. Results
41 (97.6%) eyes were saved as an organ.
41 patients (97.6%) got relief from pain.
All saved eye balls achieved normal outlook.
Observations during surgery:
The operation was technically easy to
perform.
Easy insertion of micro-drainage through
tunnel.
Controlled filtration of aqueous humour
through drainage – no sudden gush of
fluid.
No loss of anterior chamber.
No case of hemorrhagic choroidal effusion.

10. Results
Observations in post-operative period:
IOP without medication was controlled in 34 patients (80.9%)
IOP with medication was controlled in 97.6% cases.
The mean IOP decrease was 18.1 +/-2.5 mmHg (range: 11–20
mmHg, 56% decrease, P<0.05).
Shallow AC due to choroidal effusion was observed in 11 cases
(26.2%). In 2 cases the effusion dissolved spontaneously, in
9 cases a sclerotstomy was required.
With in 1 year after operation a swollen cataract was removed by
phacoemulsification in 3 cases (7.1%).
During follow-up not a single case of ocular hypotony was
observed.

11. SSWMDD in the anterior chamber –
gonioscopic view

12. а Outlook of the eye ball after 3 months
b Outlook of the eye ball after 6 months Marvel B-scan with UBM
(Appasamy medical
equipments (P) ltd, India).
c Outlook of the eye ball after 1 year

13. Conclusions
SSWMDD filtration procedure is
technically simple and safe to perform
and in long terms effectively controls
IOP in patients with RPOAG.