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Paul Baciu, Aly R Sheraly, David Crandall, Nauman R Imami; All-Cause Mortality Following Combined Cataract Extraction and Minimally Invasive Glaucoma Surgery Compared to Cataract Extraction Alone and Traditional Glaucoma Surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6125.
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There is currently limited knowledge regarding the mortality rates of minimally invasive glaucoma surgery (MIGS). This study investigates the short-term risk of all-cause mortality within 1 year following cataract extraction combined with MIGS compared to cataract extraction alone as well as traditional glaucoma surgery in an urban population setting.
Retrospective chart review of medical records of consecutive patients who underwent cataract extraction, cataract extraction combined with MIGS (ExPress shunt, iStent, canaloplasty, endocyclophotocoagulation of the ciliary body, or trabectome) and traditional glaucoma surgery (bypass drain surgery or traditional filtering surgery). Exclusion criteria included eyes with a history of narrow angle, mixed mechanism, neovascular, or uveitic glaucoma. Eyes with prior history of glaucoma or retinal surgery were also excluded. Mortality rates were calculated at 1, 3, 6, and 12 months from date of surgery.
All surgeries were completed in 2012 by two senior glaucoma surgeons. The average age at time of surgery was 73.4 in the cataract extraction alone group, 72.6 in the combined cataract and MIGS group, and 83.0 in the traditional glaucoma surgery group. The 12 month mortality rate was 3% in the cataract extraction group alone and less than 1% in the other two groups. Comorbidities in the three groups were similar though the traditional glaucoma surgery group had patients with more cardiac and renal comorbidities.
Our study found low mortality rates for cataract extraction combined with MIGS, cataract extraction alone and traditional glaucoma surgery. This is the first study to evaluate mortality outcomes in MIGS procedures and shows that rates are similar to those in previously published studies evaluating cataract surgery alone. Recognizing the all-cause mortality rates associated with these procedures improves the decision making and informed consent process for surgeons and their patients.
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