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Author Notes:

Anastasios P. Costarides, MD, PhD, Emory Eye Center, 1365-B Clifton Rd, Suite 6152B, Atlanta, GA 30322 (e-mail: a.costarides@emoryhealthcare.org)

The sponsor or funding organization had no role in the design or conduct of this research.

The authors report no conflicts of interest.

Subjects:

Research Funding:

Supported by NIH Departmental Core Grant EY006360 and Research to Prevent Blindness, Inc, New York, New York.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Ophthalmology
  • glaucoma drainage device
  • transscleral cyclophotocoagulation
  • glaucoma surgery
  • LASER TRANSSCLERAL CYCLOPHOTOCOAGULATION
  • PRIMARY SURGICAL-TREATMENT
  • TUBE SHUNT FAILURE
  • REFRACTORY GLAUCOMA
  • COMPLICATIONS
  • OUTCOMES
  • SURGERY
  • BAERVELDT

A Comparison of Sequential Glaucoma Drainage Device Implantation versus Cyclophotocoagulation Following Failure of a Primary Drainage Device

Tools:

Journal Title:

Journal of Glaucoma

Volume:

Volume 26, Number 4

Publisher:

, Pages 311-314

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Purpose: To compare sequential glaucoma drainage device (GDD) implantation with transscleral diode cyclophotocoagulation (CPC) following failure of a primary GDD. Materials and Methods: A retrospective review of all patients who underwent GDD implantation at a single institution over 10 years. Patients who required an additional GDD and/or CPC were analyzed. Success was defined as absence of loss of light perception, reoperation for glaucoma, and intraocular pressure (IOP) > 21 or < 6 at 2 consecutive visits after an initial 3-month period. Results: Thirty-two patients received sequential GDD. Twenty-one underwent CPC. Cohorts were statistically similar in regards to age, sex, race, and number of previous surgeries. Preoperatively, the GDD cohort had a lower IOP and better visual acuity. The mean length of follow-up was 37.9 months for the GDD group and 46.3 months for CPC. Both procedures significantly reduced IOP; however, CPC led to a greater reduction (P=0.0172). Survival analysis found the 5-year probability of surgical success to be 65.3% for sequential GDD and 58.0% for CPC (P=0.8678). No cases of phthisis occurred in either group. There were 2 cases of endophthalmitis (6.3%) in the GDD group, and none in the CPC group. In eyes without preexisting corneal edema, estimated corneal decompensation probability at 3 years was 31.6% for GDD and 6.7% for CPC (P=0.0828). Conclusions: Sequential GDD and CPC are both effective at reducing IOP following the failure of a primary GDD. CPC after GDD failure warrants further investigation as it led to a greater reduction in IOP with fewer serious adverse events.

Copyright information:

© 2016 Wolters Kluwer Health, Inc. All rights reserved.

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