Intermediate-term outcomes of combined phacoemulsification and Aurolab aqueous drainage implant in eyes with refractory glaucoma and coexistent cataract.

Abstract

To investigate the efficacy and safety of non-valved Aurolab aqueous drainage implant (AADI) surgery combined with phacoemulsification in eyes with refractory glaucoma and coexistent cataract. Included patients of 18years or older who underwent combined AADI-Phacoemulsification from June 2015 to January 2017 with at least 12months of consecutive follow-up. The best-corrected visual acuity, intraocular pressure (IOP), and the number of IOP-lowering medications were recorded at baseline, 2weeks, 1, 3, 6, 12, 18, and 24months. Cumulative probability of success was defined as IOP < 18mmHg or 30% reduction from the baseline at two consecutive postoperative visits after 3-months. Loss of light perception or reoperation for uncontrolled glaucoma or a complication was considered failure apart from IOP criteria. Seventeen eyes of 17 patients with a mean follow-up of 22.6 ± 4.0months were included. Baseline IOP and ocular hypotensive drugs reduced significantly from 27.9 ± 7.6mmHg to 14.0 ± 3.0mmHg (p < 0.001) and 3.24 ± 0.7 to 1.33 ± 1.1 (p = 0.001), respectively, at 24months. Cumulative probability of qualified success was 71.4% (95% Confidence Interval [CI] 40.6-88.2%) at 3months and was maintained from 6months onwards at 64.3% (95% CI 34.3-83.3%), up to 2years. Intravitreal steroid was injected in one eye (5.9%) of chronic cystoid macular edema, and tube repositioning was done in another for focal corneal decompensation. Combined AADI-Phacoemulsification surgery is a safe and effective option in providing favorable visual and IOP outcomes at an affordable cost in eyes with refractory glaucoma and coexistent cataract.