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Abstract #25073 Published in IGR 12-1
Sequential glaucoma implants in refractory glaucoma
Anand A; Tello C; Sidoti PA; Ritch R; Liebmann JMAmerican Journal of Ophthalmology 2010; 149: 95-101
PURPOSE: To evaluate the efficacy of a second glaucoma implant in eyes with prior glaucoma implant surgery and inadequate intraocular pressure (IOP) control. DESIGN: Retrospective observational cohort study. METHODS: Patients undergoing a second glaucoma implant surgery from 1996 to 2008 were included. Outcome measures included visual acuity, IOP, glaucoma medication use, and complications. Success was defined as IOP < 21 mm Hg (criterion 1) and IOP < 17 mm Hg (criterion 2), with at least 25% reduction in IOP and no prolonged hypotony. RESULTS: Forty-three eyes (43 patients) had a mean follow-up of 32.6 +/- 21.6 months. Life-table analysis demonstrated success rates of 93%, 89%, and 83% using criterion 1 and 83%, 75%, and 75% using criterion 2 at 1, 2, and 3 years, respectively. At last follow-up, mean IOP (13.6 +/- 4.6 vs 24.7 +/- 7.5 mm Hg; P < .001) and mean number of medications (1.4 +/- 1.2 vs 3.9 +/- 1.2; P < .001)were lower following the second implant. There was no difference in preoperative and most recent logarithm of the minimal angle of resolution (logMAR) visualacuities (0.86 +/- 0.13 vs 1.1 +/- .13; P = .07). The most frequently usedsecond implants were similar in percentage IOP reduction (Baerveldt implant, 45+/- 19%; Ahmed valve, 40 +/- 18%; P = .4). CONCLUSIONS: A second glaucoma implant may effectively lower IOP in eyes with refractory glaucoma.
New York Eye and Ear Infirmary, New York, New York, USA.
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)