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Anjali B Sheth, Bac Tien Nguyen, Gregory W Oldham, Sylvia Karina Casas de Leon, Benjamin Campbell, Ronald L Gross, Yvonne I Chu, Silvia Orengo-Nania, Peter T Chang, Benjamin J Frankfort; Comparison of Pre-Operative Characteristics and Tube Shunt Model in the Long-Term Surgical Management of Glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2712.
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To evaluate the long-term outcomes of tube shunt surgeries (IOP, need for medications) performed at a tertiary attending medical practice according to tube shunt type (Ahmed FP-7, Baerveldt 103-250 and Baerveldt 101-350) and baseline patient characteristics (gender, ethnicity, glaucoma type).
A retrospective chart review was performed on all tube shunt surgeries performed in the Baylor College of Medicine faculty practice between 1/1/2000 and 6/30/2010. Patients were not excluded based on type of tube shunt implant, past ocular history, past surgical history, or type of glaucoma. The primary outcome was intraocular pressure (IOP) and secondary outcomes included IOP difference from baseline, medication need, visual acuity, and complications. Data was collected for the following time points: post operative month (POM) 1, POM 2, POM 6, post operative year (POY) 1, POY 2, and POY 3. Parametric and non-parametric statistics were used as required.
Mean IOP by did not differ according to tube shunt type, gender, or glaucoma type, but did differ according to ethnicity (ANOVA with repeated measures with p = 0.012 for all ethnicites; Bonferroni correction of p = 0.009 for Caucasian vs. Black). Mean IOP difference from baseline did not differ according to tube shunt type, gender, or ethnicity, but did differ according to glaucoma type comparing POAG to all other glaucomas (ANOVA with repeated measures with p < 0.001 and non-POAG glaucoma types showing a greated IOP difference). Medication need did not differ according to tube shunt type, gender, or glaucoma type, but did differ according to ethnicity (ANOVA with repeated measures with p = 0.027 for all ethnicites; Bonferroni correction of p = 0.083 for Caucasian vs. Hispanic and p = 0.092 for Caucasian vs. Black with Caucasian medication need lowest at all time points). Visual acuity differences are currently under evaluation.
Our study shows that both Ahmed and Baerveldt tube shunts have similar IOP lowering effects as well as a similar need for additional topical medications for IOP control. Differences in pre-operative characteristics such as glaucoma type and ethnicity impacted final outcomes of both IOP control and medication need.
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