Laser-Assisted Opening of Gold Micro Shunt’s Windows in Glaucoma: Efficacy and Safety
Bibliographic record
Abstract
Objective: To determine the intraocular pressure-lowering effect and safety of opening the Gold Micro Shunt Plus' (GMS+) windows with a titanium-sapphire laser.Design: Retrospective case series.Participants: The charts of 5 patients were reviewed.Diagnoses included primary open-angle glaucoma (n=3), aphakic glaucoma (n=1) and neovascular glaucoma (n=1).There were 4 males and 1 female, aged between 56 and 81 (mean age 70±11).They had undergone a mean of 2±1.6 surgeries (range: 0-4) before GMS implantation.Methods: IOP and number of glaucoma medications were recorded before and after the implantation of the GMS in 5 patients, as well as before and after the opening of the GMS' windows with a titanium-sapphire (Ti-Sap) laser.Patients were assessed for complications arising from implanting the GMS and opening its windows.Follow-up lasted 17 to 42 months.Results: The GMS+ had 8 closed windows and one open flow port upon implantation.Four of these windows were opened in all five patients.Mean IOP before GMS implantation was 29.9±8.5 mmHg and it was 18.6±6.5mmHg after implantation.Hence, implantation of the GMS was associated with an average decrease in IOP of 11.3±4.2mmHg or 37.0% (p=0.076).The mean IOP before window-opening was 24.9±5.8mmHg and after window opening, it was 17.6±5.7 mmHg.The IOP thus dropped 7.3±4.6mmHg or 29.3% (p=0.055) on average after opening the Original Research ArticleCadet and Harasymowycz; OR, 4(3): 83-88, 2015; Article no.OR.2015.03384 GMS' windows.The windows were opened an average 6.4±4.5 months after GMS implantation.IOP at follow-ups remained lower than pre-GMS levels in all patients.The IOP reduction post window opening lasted throughout follow-up, i.e. from 17 to 42 months (average 30±10 months).The number of glaucoma drops for each patient did not decrease after opening the GMS' windows.One patient developed transitory cystoid macular edema after GMS implantation that resolved with a course of NSAID drops.No complications arose from the opening of the GMS' windows.Conclusions: In our small case series, opening the GMS' windows was safe and was associated with a substantial and sustained reduction in IOP.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".