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PURPOSE: To identify the risk factors for glaucoma drainage device (GDD) exposure in children. DESIGN: Retrospective case-control study. METHODS: ???. Setting Tertiary care eye hospital Patient or Study Population Children (one eye each) who presented with a history of GDD exposure over the period January 2014 to January 2020. Inclusion/exclusion criteria Consecutive children (age <18 years) were Included. A control group from the same time period (children without GDD exposure) were included in the ratio of 5 controls to every 1 case of exposure. Observation Procedure(s) GDD exposure MAIN OUTCOME MEASURE: (s) Risk factors for exposure (univariate and multivariate analysis). RESULTS: A total of 21 eyes (of 21 children with implant exposure) and 115 eyes, (of 115 children without exposure) were included in this study. During the same study period, a total of 494 eyes had undergone GDD implantation, giving an estimated incidence of exposure of 4.25%). In the bivariate analysis, GDD exposure was associated with multiple previous ocular surgeries (P = 0.001), longer follow up duration (P = <0.001), combined procedure at the time of primary implantation (P = 0.002), and a younger age at the time of primary implantation (P = 0.006). The former three risk factors continued to prove a statistically significant association on multivariable regression analysis. Postoperative use of eye lubricants was more common among children in the control group (P = 0.007). CONCLUSION: In pediatric glaucoma patients, younger age and combined procedure at time of primary GDD implantation, in addition to multiple previous ocular surgeries were associated with greater risk of implant exposure. Postoperative use of eye lubricants may be protective.
Glaucoma Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
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