June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Perception of Cornea and Glaucoma Subspecialists Regarding Prevalence of Corneal Decompensation with Ex-Press Shunt Placement
Author Affiliations & Notes
  • Shalin Shah
    Department of Ophthalmology, Louisiana State University Eye Center, LSU School of Medicine, LSU Health Sciences Center, New Orleans, LA
  • Ngo Yen
    Department of Ophthalmology, Louisiana State University Eye Center, LSU School of Medicine, LSU Health Sciences Center, New Orleans, LA
  • Thompson Hilary
    Biostatistics Section, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA
  • Jayne Weiss
    Department of Ophthalmology, Louisiana State University Eye Center, LSU School of Medicine, LSU Health Sciences Center, New Orleans, LA
  • Footnotes
    Commercial Relationships Shalin Shah, None; Ngo Yen, None; Thompson Hilary, None; Jayne Weiss, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1665. doi:
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      Shalin Shah, Ngo Yen, Thompson Hilary, Jayne Weiss; Perception of Cornea and Glaucoma Subspecialists Regarding Prevalence of Corneal Decompensation with Ex-Press Shunt Placement. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1665.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Corneal decompensation is a recognized complication associated with anterior chamber insertion of Ahmed, Baerveldt and Molteno (ABM) shunts. By comparison, there are no publications addressing corneal decompensation after Ex-Press shunt placement. The purpose of this study was to assess the prevalence and onset of corneal decompensation with ABM shunts and Ex-Press shunts as perceived by cornea and glaucoma specialists.

Methods: A survey was distributed to members of the Cornea Society and Glaucoma Society with questions about frequency and onset of complications after anterior chamber placement of ABM and Ex-Press shunts. The individual was requested to rank the following side effects in order of perceived prevalence: chronic hypotony, corneal decompensation, endophthalmitis, infection, malignant glaucoma, pthisis bulbi, and retinal detachment. Time of onset to corneal decompensation in Ex-Press shunts was compared to that of the ABM group.

Results: 17 glaucoma subspecialists and 22 cornea subspecialists participated. Corneal decompensation was listed as the most prevalent of the seven possible complications by both subgroups (chi square < .001). 65.0% of cornea subspecialists and 84.6% of glaucoma subspecialists reported the risk of corneal decompensation to be higher with uncomplicated ABM placement than with Ex-Press shunts (chi square <0.001). The two subgroups also agreed the onset to decompensation was less than two years in the ABM group (57.1% cornea participants, 68.4% glaucoma participants) compared to greater than 2 years in the Ex-Press shunt group (72.7 % cornea respondents, 85.7% glaucoma respondents) (chi square <0.001). 53.8% of cornea respondents and 58.3% of glaucoma respondents reported onset in the Ex-Press shunt group was greater than 5 years.

Conclusions: The results of the survey show a statistically significant agreement among both glaucoma and cornea subspecialists that corneal decompensation is the most prevalent complication of those queried. They also agree decompensation is more prevalent and has a shortened onset in ABM shunts than in Ex-Press shunts. Although there is little literature on corneal decompensation associated with Ex-Press shunts, this initial survey suggests the complication may occur less frequently and is delayed with Ex-Press shunts, thus warranting further investigation.

Keywords: 481 cornea: endothelium • 479 cornea: clinical science • 463 clinical (human) or epidemiologic studies: prevalence/incidence  
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