Abstract
Purpose To compare safety and efficacy between a low-cost glaucoma drainage device (GDD), the Aurolab aqueous drainage implant (AADI), and the Baerveldt glaucoma implant (BGI) in refractory childhood glaucoma in Egypt. Methods This is a retrospective study of patients who received either an AADI or BGI at a tertiary care postgraduate teaching institute. Children aged <16 years with uncontrolled intraocular pressure (IOP) with or without prior failed trabeculectomy who completed a minimum 6-month follow-up were included. The outcome measures were IOP reduction from preoperative values and postoperative complications. Results Charts of 57 children (younger than 16 years old) diagnosed with refractory childhood glaucoma were included. Of these, 27 eyes received AADI implants (group A), while 30 received BGI implants (group B). The mean preoperative baseline IOP was 34 ± 5 mmHg in group A versus 29 ± 2 mmHg in group B (p=0.78) in patients on maximum allowed glaucoma medications. In group A versus group B, the mean IOP decreased to 13.25 ± 8.74 mmHg (p=0.6), 12.8 ± 5.4 mmHg (p=0.7), and 12.6 ± 5.6 mmHg (p=0.9) after 1 week, 3 months, and 6 months, respectively. However, in group A, an anterior chamber reaction appeared around the tube in 14 cases starting from the first month and resolved with treatment in only 4 cases. In the other 10 cases, the reaction became more severe and required surgical intervention. This complication was not observed in any eye in group B. Conclusion AADI, a low-cost glaucoma implant, is effective in lowering IOP in patients with recalcitrant paediatric glaucoma. However, an intense inflammatory reaction with serious consequences developed in some of our patients; we believe these events are related to the valve material. We therefore strongly recommend against its use in children.
Highlights
Childhood glaucoma is a blinding disease with a prevalence of 0.1/1000 to 1.1/1000 in children in different parts of the world, but a remarkably higher prevalence in developing countries [1, 2]
At approximately 1/15, the price of the Baerveldt glaucoma implant (BGI) is a very strong advantage, and the efficacy and safety of Aurolab aqueous drainage implant (AADI) implant was comparable with BGI in Journal of Ophthalmology recent studies [5, 6], but little data are available regarding the safety and efficacy of the AADI outside India, the manufacturing country of the device
This is a retrospective study of children who had either AADI implants or BGI implants who were included in group A and B, respectively
Summary
Childhood glaucoma is a blinding disease with a prevalence of 0.1/1000 to 1.1/1000 in children in different parts of the world, but a remarkably higher prevalence in developing countries (up to 0.051%) [1, 2]. Glaucoma drainage devices (GDDs), such as the Ahmed glaucoma valve (AGV) or Baerveldt glaucoma implant (BGI), have been reported to have high success rates in the management of childhood glaucoma when used in either a primary surgical procedure or following other angle-based glaucoma surgeries, such as trabeculectomy [3]. A low-cost prototype of the Baerveldt implant that has recently become available called the Aurolab aqueous drainage implant (AADI, Aurolabs, Madurai, India). At approximately 1/15, the price of the BGI is a very strong advantage, and the efficacy and safety of AADI implant was comparable with BGI in Journal of Ophthalmology recent studies [5, 6], but little data are available regarding the safety and efficacy of the AADI outside India, the manufacturing country of the device
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
