FDA Adverse Event Injury Summary report: N

BAERVELDT GLAUCOMA IMPLANT (250)

MDR report key: 12022762 · Received June 18, 2021

Report

Report Number
9614546-2021-07241
Event Type
Injury
Date Received
June 18, 2021
Report Date
June 17, 2021
Manufacturer
AMO MANUFACTURING NETHERLANDS
Product Code
KYF
PMA / PMN Number
K905129
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

AGE/DATE OF BIRTH: MEAN AGE: 55.00 ± 14.35 YEARS. SEX/GENDER: 26 MALES AND 19 FEMALES. DATE OF EVENT: EXACT DATES NOT PROVIDED, ARTICLE ACCEPTANCE DATE IS OCTOBER 1, 2020. SERIAL NUMBER: UNKNOWN, INFORMATION NOT PROVIDED. MODEL NUMBER: UNKNOWN, AS THE SERIAL NUMBER WAS NOT PROVIDED. EXPIRATION DATE: UNKNOWN, AS THE SERIAL NUMBER WAS NOT PROVIDED. UDI NUMBER: UDI NUMBER IS UNKNOWN, AS THE SERIAL NUMBER WAS NOT PROVIDED. IMPLANT DATE: UNKNOWN, INFORMATION NOT PROVIDED. EXPLANT DATE: NOT APPLICABLE, AS THERE IS NO INDICATION THAT THE DEVICE WAS EXPLANTED. PHONE NUMBER: (B)(6). THE DEVICE WAS NOT RETURNED FOR ANALYSIS. THE SERIAL NUMBER FOR THE DEVICE IS NOT AVAILABLE; THEREFORE, NO FURTHER INVESTIGATION CAN BE PERFORMED. IF THERE IS ANY FURTHER RELEVANT INFORMATION RECEIVED, A SUPPLEMENTAL MEDWATCH WILL BE FILED. DEVICE MANUFACTURE DATE: UNKNOWN, AS THE SERIAL NUMBER WAS NOT PROVIDED. (B)(4). CITATION: WATANABE, S., HAMANAKA, T., SAKURAI, T., KOBAYASHI, K., ISHIDA, N., EBIHARA, N., EVALUATION OF THE OUTCOME OF LONG-TUBE SHUNT IMPLANT SURGERY IN UVEITIC GLAUCOMA PATIENTS BY ANALYZING THE BACKGROUND OF UVEITIS, (2021), INT OPHTHALMOL, 41:PP. 509¿517. ALL PERTINENT INFORMATION AVAILABLE TO JOHNSON & JOHNSON SURGICAL VISION, INC. HAS BEEN SUBMITTED.

Description of Event or Problem · 1

THE FOLLOWING ARTICLE WAS RECEIVED BASED ON A LITERATURE REVIEW: TITLE: EVALUATION OF THE OUTCOME OF LONG-TUBE SHUNT IMPLANT SURGERY IN UVEITIC GLAUCOMA PATIENTS BY ANALYZING THE BACKGROUND OF UVEITIS. A RETROSPECTIVE STUDY WAS DONE TO EVALUATE THE EFFICACY OF LONG-TUBE SHUNT SURGERY (LTSS) WITHOUT VALVE IN UVEITIC GLAUCOMA (UG) EYES. A TOTAL OF 45 EYES OF 41 JAPANESE UG PATIENTS UNDERWENT LTSS (N=21) OR LTSS COMBINED WITH TRABECULECTOMY (TLE) (N=24). THE TYPES OF LTSS PERFORMED WERE BAERVELDT 250 (N=16 EYES; JOHNSON & JOHNSON VISION), BAERVELDT 350 (UG GROUP: N=18 EYES; JOHNSON & JOHNSON VISION), AND DOUBLE-PLATE MOLTENO GLAUCOMA DRAINAGE DEVICE (N=11 EYES; MOLTENO OPHTHALMIC LTD). SEVEN (7) EYES WERE CLASSIFIED AS SURGICAL TREATMENT FAILURE DUE TO IOP OF MORE THAN 22 MMHG (N=5 EYES), AN INSUFFICIENT IOP DECREASE OF LESS THAN 20% (N=1 EYE), AND PLATE EXPOSURE (N=1 EYE). RECURRENCE OF IRITIS WAS OBSERVED IN 7 EYES AND CORNEAL EDEMA OCCURRED IN 4 EYES. CORNEAL TRANSPLANTATION WAS PERFORMED IN 2 OF THOSE 4 EYES WITH CORNEAL EDEMA AS INTERVENTION. IT IS NOT CLEAR IF THESE COMPLICATIONS OCCURRED IN THE EYES IMPLANTED WITH BAERVELDT 250, BAERVELDT 350 OR THE OTHER PRODUCT. THIS REPORT IS FOR THE BAERVELDT 250 DEVICE. A SEPARATE REPORT WILL BE SUBMITTED FOR THE BAERVELDT 350 DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
925310 BAERVELDT GLAUCOMA IMPLANT (250) IMPLANT, EYE VALVE KYF AMO MANUFACTURING NETHERLANDS BG103250

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention