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Abstract #49127 Published in IGR 14-1
Practice preferences for glaucoma drainage device implantation and cyclodestruction in Australia and New Zealand
Chow K; Mora JJournal of Glaucoma 2012; 21: 199-205
PURPOSE: To evaluate the practice patterns in the use of glaucoma drainage devices (GDD) and cyclodestruction among consultant ophthalmologists in Australia and New Zealand. MATERIALS AND METHODS: A 22-part questionnaire regarding GDD implantation and cyclodestruction practices was sent to all ophthalmologists registered with the Royal Australian and New Zealand College of Ophthalmologists in 2008 by post or e-mail. RESULTS: Sixty-six percent of 872 questionnaires were returned, of these, 14% were from glaucoma subspecialists. Ten percent of all respondents performed GDD implantations. Molteno drains were the most popular device (69%). The most commonly recognized indications for GDD implantation were a history of 2 failed trabeculectomies (85%), neovascular glaucoma (71%), iridocorneal endothelial syndrome (55%), and uveitic glaucoma (52%). Only a minority of surgeons used intraoperative mitomycin C (38%) or 5-fluorouracil (26%) when implanting GDD. Cyclodestruction had been performed by 20% of all respondents. External diode cyclophotocoagulation was the most preferred treatment mode (73%). Sixty-seven percent treated 180 degrees of the ciliary body during initial treatment. Fifty-five percent treated only the earlier untreated area during retreatment. Only 11% of surgeons who performed cyclodestruction agreed that the indications for cyclodestruction are expanding. CONCLUSIONS: A wide range of practice patterns for GDD implantation and cyclodestruction exist among Australian and New Zealand ophthalmologists. This likely reflects a paucity of good evidence to guide practice. The Australasian indications for GDD implantation were moderately different from the reported practice in America. Well-designed clinical trials are needed to better define the indications and best practice for these 2 important glaucoma treatment modalities.
Department of Ophthalmology, Waikato Hospital, Hamilton, New Zealand. drkentchow@gmail.com
Full articleClassification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
