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Robert J. Noecker, MD, MBA Kimberly V. Miller, MD

Comparison of surgical times for tube placement in glaucoma drainage device surgery using standard methods versus micro-forceps for insertion. Robert J. Noecker, MD, MBA Kimberly V. Miller, MD.

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Robert J. Noecker, MD, MBA Kimberly V. Miller, MD

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  1. Comparison of surgical times for tube placement in glaucoma drainage device surgery using standard methods versus micro-forceps for insertion. Robert J. Noecker, MD, MBA Kimberly V. Miller, MD The authors of this poster received research funding from National Institutes of Health CORE Grant P30 EY008098, Eye and Ear Foundation of Pittsburgh, and Research to Prevent Blindness, New York, NY. The authors have no conflicts of interest. UPMC Eye Center, Department of Ophthalmology University of Pittsburgh School of Medicine Ophthalmology & Visual Science Research Center The Eye & Ear Institute millerkv@upmc.edu

  2. Purpose To compare the length of time used to place the tube of a glaucoma drainage device into the anterior chamber or ciliary sulcus using standard methods or using 25-gauge vitreoretinal microforceps (D.O.R.C.).

  3. Methods • 24 videos of glaucoma drainage device (GDD) surgery were reviewed. • 16 (66%) used standard Hoskins forceps and 8 (33%) used D.O.R.C. forceps. • D.O.R.C. microforceps were used to insert the tube tip through the sclerotomy in superotemporal cases, and were inserted through a corneal paracentesis incision out through sclera and used to pull the tube tip into the eye in inferonasal cases.

  4. Superotemporal insertion

  5. Inferonasal insertion

  6. Results Average total case time for GDD surgery using 25G microsurgical forceps was 16.0 ± 4.8 minutes, and using standard forceps was 22.4 ± 8.0 minutes. The use of 25G microsurgical forceps shortened total case time by 28.3%, p=0.032.

  7. Results Average time for insertion of GDD tube using 25G microsurgical forceps was 0.6 ± 0.3 minutes, and using standard forceps was 3.2 ± 2.3 minutes. The use of 25G microsurgical forceps shortened time of tube insertion by 80.1%, p=0.002.

  8. Results – Total Case Time (min)

  9. Results – Tube Insertion Time (min)

  10. Conclusions 25G microsurgical forceps shorten GDD surgical time. This may lead to improved surgical efficiency, greater patient safety and comfort, and lower overall healthcare spending.

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