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Bac Tien Nguyen, Anjali B Sheth, 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; Long-term outcomes of tube shunt surgery for the management of glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2713.
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To evaluate the long-term outcomes of tube shunt surgeries performed at a tertiary medical practice (Baylor College of Medicine) regardless of past ocular history, past surgical history, or type of glaucoma.
This is a retrospective chart review study that investigated 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) at three years. Secondary outcomes included medication need and complications.
211 patients (112 male, 99 female) were included in the analysis. The mean age of all participants was 61.93 years. Patient ethnicities were 90 Caucasian, 28 Hispanic, 79 Black, and 14 Asian. 90 patients had primary open angle glaucoma (POAG), while 121 had a non-POAG glaucoma diagnosis including secondary, inflammatory, neovascular, traumatic, chronic angle closure, congenital, steroid-induced, developmental, and low tension. 47 patients received an Ahmed Glaucoma Valve FP7 (New World Medical, Rancho Cucamonga CA), 63 received a Baerveldt Glaucoma Implant (BGI) 103-250 (Abbott Medical Optics, Abbott Park, IL) and 101 received a BGI 101-350. The mean baseline IOP was 28.67 mmHg with a standard deviation (SD) of 11.34. At three years of follow up, the mean IOP was 15.65 mmHg with a SD of 6.94. The mean IOP reduction at three years of follow up was 13.01 mmHg with a SD of 12.27. The mean number of IOP lowering medications at three years of follow up was 1.63 with a SD of 1.29. 18 patients (8.5%) underwent additional glaucoma incisional or laser surgery within the three year follow up period. 47 patients (22%) experienced at least one postoperative complication.
In a tertiary practice that treats eyes with wide range of past ocular histories, past surgical histories, and glaucoma types, tube shunt surgery is effective surgical management of glaucoma. The percentage of patients who underwent additional glaucoma surgical intervention was similar to previously reported studies. The number of patients with postoperative complications was lower than recently published studies.
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