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Jennifer Lee, John Choi, Tak Yee Tania Tai; Outcomes of Glaucoma Drainage Implant Surgery Performed by Residents. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6485.
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© ARVO (1962-2015); The Authors (2016-present)
In recent years, aqueous drainage devices have increasingly been used in the treatment of glaucoma. While studies have compared the outcomes of the two most commonly implanted aqueous drainage devices, the Ahmed Valve and the Baerveldt implant, none included those performed by residents in training. The purpose of our study is to evaluate the outcomes of various aqueous drainage devices implanted by residents under the supervision of experienced glaucoma surgeons.
We performed a retrospective chart review on patients who had an aqueous drainage device implanted by residents at the New York Eye and Ear Infirmary from 2011-2014. Informed recorded from the medical record included: patient demographics, preoperative diagnosis, type of device implanted, surgical time, preoperative intraocular pressure (IOP), postoperative IOP at month 1, 3, 6, and 12, number of glaucoma medications, preoperative and postoperative visual acuity, and postoperative complications.
There were a total of 103 eyes included in the study. The following types of implants were included in the analysis: 45 Ahmed FP7; 13 BGI 250; 33 BGI 350. Mean preoperative IOP was 37.2 +/- 11.8mmHg. There were no significant differences in IOP at month 1 while there was a trend toward significance at month 3 (P=0.06), with the highest IOP in the Ahmed group(20.1mmHg). At 6 months follow-up, there was a significant difference (P=0.01) in IOP with the highest mean IOP in patients who received Ahmed implants (18.0 mmHg), followed by those with BGI 250 (16.8 mmHg) and BGI 350 (14.6 mmHg). By 12 months, there was no longer a significant difference in IOP between the three groups. During the post-operative period at month 1, the mean number of meds was lowest in the Ahmed group (2.4, P=0.05). There was no significant difference in the surgical time or the number of postoperative medications after month 1 between the groups.
In this study of glaucoma surgeries performed by residents, both the Ahmed and Baerveldt devices were effective in reducing IOP at 1-year follow-up, with no significant difference in IOP.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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