Abstract
BackgroundTo evaluate long-term results of eyes with glaucoma drainage device (GDD).MethodsWe retrospectively reviewed medical records of all patients who underwent GDD placement at our institution between 2001 and 2014. A total of 110 eyes of 90 patients were studied. Glaucoma outcome was assessed by postoperative intraocular pressure (IOP), number of medications, and need for further glaucoma surgery. Surgical procedures before and during the study period, and their complications were evaluated.ResultsThe mean follow-up was 78.3 ± 44.0 months. The mean preoperative intraocular pressure was 30.8 ± 6.9 mmHg with 3.5 ± 1.1 glaucoma medications. At last postoperative follow-up, the mean IOP decreased to 14.3 ± 5.4 mmHg with 1.6 ± 1.5 glaucoma medications. GDD implantation successfully controlled glaucoma in 86, 85, 81, 78, 79, 76 and 73% of eyes at 1, 2, 3, 4, 5, 7 and 10 years, respectively. At last follow-up IOP was successfully controlled in 67% of eyes. Clinical complications occurred in 56.4% of eyes during the follow-up period.ConclusionsA glaucoma drainage device can successfully control intractable glaucoma even after a very long period of time.
Highlights
To evaluate long-term results of eyes with glaucoma drainage device (GDD)
Success for glaucoma control was defined as a postoperative Intraocular pressure (IOP) ≥ 5 Millimetre of mercury (mmHg) and ≤ 21 mmHg with or without application of antiglaucoma medications, with no need for further glaucoma surgery and without loss of light perception at last follow-up
Glaucoma diagnoses were divided into different types
Summary
To evaluate long-term results of eyes with glaucoma drainage device (GDD). Glaucoma is a leading cause of blindness worldwide [1]. The use of glaucoma drainage devices (GDDs) has become a widely used therapy option for the management of eyes with complicated glaucoma refractory to standard trabeculectomy with adjunctive antifibrotics This trend is following the results of the Tube Versus Trabeculectomy study, which reported a better success rate at 5 years with Baerveldt implantation than with trabeculectomy with mitomycin-C in patients who had undergone previous surgery [4]. Two of the most common devices are the valved Ahmed Glaucoma Valve (AGV; New World Medical, Rancho Cucamonga, CA, USA) and the non-valved Baerveldt Glaucoma Implant (BGI; Abbott Medical Optics, Abbott Park, IL, USA) These devices have been shown to be effective in lowering IOP for the treatment of glaucoma in patients with a variety of glaucomas in whom medical therapy or multiple trabeculectomies have failed or are expected to have a very low chance of surgical success [6,7,8,9]. They vary from 68 to 100% for the Ahmed Glaucoma Valve and from 43 to 100% for the Baerveldt Glaucoma Implant [5]
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