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 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

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.).

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.

Superotemporal insertion

Inferonasal insertion

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.

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.

Results – Total Case Time (min)

Results – Tube Insertion Time (min)

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.

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

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

Presentation Transcript

Deepak L. Bhatt, MD, MPH, Ph. Gabriel Steg, MD, Michael Miller, MD,

Robert Silverman, MD

Robert Burkich MD

Kimberly V. Miller, MD Jeremy B. Wingard , MD Michael J. Pokabla , MD Korinn M. Strunk

Robert Sallis, MD

Michael J. Mauro MD

Jeffrey Beal, MD Jennifer Janelle, MD Robert Lawrence, MD

Robert Sinclair, MD, PhD

Megan Miller MD, Nancy Schindler MD, John Seal MD, Mark Russo MD

Robert Yolken, MD

Robert Cionni, MD

Howard Taras, MD, FAAP Robert Murray, MD, FAAP J. Gary Wheeler, MD, FAAP

Robert M. Wachter, MD

Authors Abraham K. Sleem , MD Robert L. Schultze , MD Robert A. Eden, MD William Yang, MD

Robert R. Althoff, MD, PhD; James J. Hudziak, MD; Frank C. Verhulst, MD, PhD;

Candace Ireton, MD Kimberly Schmidt, LCSW

Robert J. Master, MD

Terry McGeeney MD, MBA

Veena Gonuguntla MD Mentor: Robert Haws MD

Gregg W. Stone, MD Manejeh Yaqub, MD; Poornima Sood, MD, MBA; Ali Rizvi, MD;

R. Diaz-Garcia MD, J. Bernardo MD

Philip Miller, MD, FACS