advertisement
Abstract #108414 Published in IGR 23-4
10-Year Clinical Outcomes of Tube Shunt Surgery at a Tertiary Care Center
Myers JS; Lamrani R; Hallaj S; Lee D; Wong JC; Wong JCAmerican Journal of Ophthalmology 2023; 253: 132-141
PURPOSE: To report 10-year clinical outcomes of tube shunt (TS) surgery at a tertiary care center. DESIGN: Retrospective cohort study. METHODS: Eyes were included that underwent a first TS surgery between January 2005 and December 2011 at a tertiary referral eye hospital and with at least 10 years of follow-up. Demographic and clinical data were collected. Failure was defined as reoperation to lower intraocular pressure (IOP), IOP > 80% of baseline for two consecutive visits, or progression to no light perception. RESULTS: Eighty-five eyes of 78 patients were included in the Study Group; 89 eyes were selected as a Comparison Group. Mean follow-up was 11.9 ± 1.7 years. Fifty-one valved (60%), 25 non-valved (29%), and nine unknown (11%) TS were placed. At the final visit, mean IOP was reduced from 29.2 ± 10.4 mmHg on 3.1 ± 1.2 medications to 12.6 ± 5.8 mmHg on 2.2 ± 1.4 (p<0.001 for each). Forty-eight eyes (56%) failed; 29 eyes (34%) underwent additional glaucoma surgery; eight eyes (10%) progressed to no light perception; and 34 eyes (40%) also required TS revision. Best corrected visual acuity (BCVA) logMAR (minimal angle of resolution) worsened from 0.8 ± 0.7 (20/125) to 1.4 ± 1.0 (20/500) at the last visit (p<0.001). Average visual field MD was -13.9 ± 7.5 dB at baseline and -17.0 ± 7.0 dB at last follow-up (P=0.0605). CONCLUSIONS: Many eyes maintained IOP control 10 years following TS, but 56% met failure criteria, 39% had substantial vision loss, and 34% underwent additional surgery. Outcomes did not differ with TS model.
From Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA (J.S.M, S.H, D.L, J-C.W); Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (J.S.M, D.L). Electronic address: jmyers@willseye.org.
Full article