10-Year Clinical Outcomes of Tube Shunt Surgery at a Tertiary Care Center

Abstract

To report 10-year clinical outcomes of tube shunt surgery at a tertiary care center. Retrospective cohort study METHODS: Eyes undergoing a first tube shunt (TS) surgery between 1/2005 and 12/2011 at a tertiary referral eye hospital with at least 10 years follow up. Demographic and clinical data were collected. Failure was defined as reoperation to lower intraocular pressure (IOP), IOP greater than 80% of baseline for 2 consecutive visits, or progression to no light perception (NLP). 85 eyes of 78 patients were included in the Study Group; 89 eyes were selected as a Comparison Group. Mean follow up was 11.9±1.7 years. 51(60%) valved, 25 (29%) non-valved, and 9 (11%) unknown TS were placed. At the final visit, mean IOP was reduced from 29.2 ± 10.4 mmHg on 3.1 ± 1.2 medications to 12.6 ± 5.8 mmHg on 2.2 ± 1.4 (IOP: p=1.0136E-12; medications: p=.00000390). 48 (56%) eyes failed. 29 (34%) eyes underwent additional glaucoma surgery. 8 (10%) eyes progressed to NLP. 34 (40%) eyes also required TS revisions. Best corrected visual acuity (BCVA) logMAR (minimal angle of resolution) worsened from .8 ± .7 (20/125) to 1.4 ± 1.0 (20/500) at the last visit (p=.00000714). Average visual field MD was -13.9 ± 7.5 dB at baseline and -17.0 ± 7.0 dB at last follow up (p=.0605) CONCLUSIONS: 10 years following tube shunt, many eyes maintain IOP control, but 56% met failure criteria, 39% had substantial vision loss and 34% underwent additional surgery Outcomes did not differ with tube shunt model.