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Abstract #78092 Published in IGR 19-4
Donor sclera versus bovine pericardium as patch graft material in glaucoma implant surgery and the impact of a drainage suture
van Hoefen Wijsard M; Haan M; Rietveld E; van Rijn LJActa Ophthalmologica 2018; 0:
PURPOSE: To compare the use of human donor sclera with bovine pericardium as patch graft material for a glaucoma drainage device (GDD), with respect to the incidence of tube exposure, and to study the role of a drainage suture. METHODS: All GDD surgeries between 2010 and 2014 performed at the VU Medical Center were examined in this comparative, retrospective cohort study. A total of 244 cases were included; 163 in the human donor sclera cohort and 81 in the bovine pericardium cohort with a median follow-up of 31 and 36 months, respectively. The primary outcome measure was occurrence of tube exposure. Survival analysis for tube exposure was carried out and Kaplan-Meier curves compared. Secondary outcomes were postoperative intraocular pressure (IOP), number of glaucoma medications and the effect of a drainage suture. RESULTS: In the bovine pericardium cohort, eleven (13.6%) eyes developed tube exposure compared to none in the human donor sclera cohort. Their Kaplan-Meier survival curves differed significantly from each other (χ² = 21.1, p < 0.001, log-rank test). Mean IOP and number of glaucoma medications did not differ significantly between patch graft materials at three months of follow-up. The use of a drainage suture directly lowered IOP after surgery in both cohorts. Within the bovine pericardium cohort, eyes with a drainage suture experienced more tube exposure, although this difference was not statistically significant (p = 0.09). CONCLUSION: Human donor sclera leads to less tube exposure than bovine pericardium. A drainage suture directly lowers IOP after surgery. With bovine pericardium, but not with donor sclera, exposure tends to be enhanced by a drainage suture.
Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.
Full articleClassification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
