Comparison of diode laser trans-scleral cyclophotocoagulation versus implantation of a 350-mm2 Baerveldt glaucoma drainage device for the treatment of glaucoma in dogs (a retrospective study: 2010-2016).

Abstract

To compare outcomes following trans-scleral cyclophotocoagulation (TSCP) and 350-mm2 Baerveldt implantation in the treatment of canine refractory glaucoma. Retrospective case study. Client owned dogs undergoing surgical treatment of glaucoma within a veterinary referral hospital. Eighty-six glaucoma surgeries were performed on 83 eyes (69 dogs) diagnosed with primary or secondary glaucoma. Medical records were retrieved, and baseline data, surgery, medications, intraocular pressures (IOPs), vision, and complications were extracted. Fifty-four eyes (44 dogs) were treated with TSCP and placement of an anterior chamber suture shunt; 28 eyes (24 dogs) were implanted with a Baerveldt glaucoma drainage device (GDD); and four eyes (4 dogs) underwent GDD implantation after failure of TSCP to manage IOP. Following TSCP, IOP control (<20 mmHg) and vision retention occurred in 81.5% and 42.6%, respectively, for 16.1 ± 1.36 months. Following GDD implantation, 71.4% maintained IOP <20 mmHg and 69.6% maintained vision for 11.0 ± 0.94 months. IOP control without loss of vision was more likely following Baerveldt implantation (17/28; 60.7%) than TSCP (19/54; 35.2%) (P = 0.027). One eye had functional vision restored following GDD placement. IOP control without adjunctive medications was more likely following Baerveldt implantation (P = 0.02). In this study, eyes treated with Baerveldt GDD implantation were more likely to maintain IOP control and retain vision compared to eyes treated with TSCP and placement of an anterior chamber suture shunt. Lack of formal randomization, inconsistencies in surgical techniques and TSCP protocols, and potential unmeasured confounders must be considered when extrapolating from this retrospective study.