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A.C. Crichton, A.M. Carlsson; Collagen Wick Nonpenetrating Glaucoma Surgery in High Risk Glaucoma Patients . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3298.
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Purpose:To review the results of non-penetrating filtration surgery utilizing the collagen wick glaucoma drainage device (CGDD) in patients at increased risk for surgical complication with trabeculectomy. Methods:A retrospective chart review was conducted on 20 patients in which the CGDD was implanted. All patients were considered at high risk for complications of filtration surgery for various reasons. Results: The average IOP pre-operatively and post-operatively was 23.7 + 4.3 mmHg and 14.9 + 3.3 mmHg respectively (p<0.01, paired T-test). The average number of glaucoma meds pre-operatively and post-operatively was 4.4 + 0.7 and 0.60 + 0.9 respectively (p<0.01, paired T-test). The number of patients off medication completely following surgery was 12/20 (60%). Laser was applied ab interno in 14/20 patients (70%) to maximize IOP control. All patients who underwent laser experienced a positive pressure control effect. The average IOP (2 measurements) pre-laser was 24.9 + 2.9 mmHg, and post-laser was 14.1 + 4.8 mmHg (p< 0.01, paired T-test).Visual acuity was unaffected following surgery in all patients. The number of patients who experienced post-operative complication was 4 (20%). Complications included choroidal effusions, hyphema, and iris incarceration; all resolved without sequelae or intervention. One patient was lost to follow-up after 15 months, one patient expired after 25 months follow-up, and one patient failed IOP control after 18 months. Conclusions: Non-penetrating glaucoma surgery that utilizes the CGDD appears to be a safe and effective procedure in patients at high risk for surgical complication with traditional filtration surgery.
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