June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Comparison of surgical outcomes of trabeculectomy, Ahmed shunt, and Baerveldt shunt in uveitic glaucoma
Author Affiliations & Notes
  • Audrey Chow
    Keck School of Medicine at the University of Southern California, Pasadena, California, United States
  • Bruce Burkemper
    Keck School of Medicine at the University of Southern California, Pasadena, California, United States
  • Rohit Varma
    Keck School of Medicine at the University of Southern California, Pasadena, California, United States
  • Damien C Rodger
    Keck School of Medicine at the University of Southern California, Pasadena, California, United States
  • Narsing A Rao
    Keck School of Medicine at the University of Southern California, Pasadena, California, United States
  • Grace Marie Richter
    Keck School of Medicine at the University of Southern California, Pasadena, California, United States
  • Footnotes
    Commercial Relationships   Audrey Chow, None; Bruce Burkemper, None; Rohit Varma, None; Damien Rodger, Allergan Inc. (C); Narsing Rao, None; Grace Richter, None
  • Footnotes
    Support   Unrestricted institutional grant from Research to Prevent Blindness (USC Roski Eye Institute), American Glaucoma Society Mentoring for Advancement of Physician Scientists (GMR)
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4953. doi:
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      Audrey Chow, Bruce Burkemper, Rohit Varma, Damien C Rodger, Narsing A Rao, Grace Marie Richter; Comparison of surgical outcomes of trabeculectomy, Ahmed shunt, and Baerveldt shunt in uveitic glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4953.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Trabeculectomy (TE), valved Ahmed shunt (AGV), and non-valved Baerveldt shunt (BGI) are surgical interventions used to control glaucoma. We performed a retrospective observational study to compare surgical outcomes among these entities in patients with uveitic glaucoma.

Methods : The records of 147 eyes (17 TE, 22 AGV, 108 BGI) from 147 patients with uveitic glaucoma at the University of Southern California Department of Ophthalmology were reviewed. Preoperative and postoperative intraocular pressure (IOP), medication use, visual acuity, complications, and time to failure were recorded. Similar to the Tube Versus Trabeculectomy and Ahmed Versus Baerveldt studies, failure was defined as postoperative IOP >21mmHg or <5mmHg with supplemental medication, reoperation, or loss of light-perception. Logistic regression, Kruskal-Wallis, Fisher’s Exact, Wilcoxon, chi-squared and log-rank tests were used for statistical analysis.

Results : There was no significant difference in baseline demographic or ocular characteristics between groups. Mean IOP, percent IOP reduction, glaucoma medication use, and visual acuity at 6 and 12 months follow-up were similar in all groups. Overall there was a significant difference in postoperative hypotony rate across TE (53%), BGI (24%), and AGV (18%) groups (P=0.027); other complication rates were similar. BGI patients had significantly lower failure rates at 6 months (P=0.0063) and 12 months follow-up (P=0.0015), as well as lower cumulative failure probability compared to TE (P=0.0054) and AGV (P=0.0008) patients. Specifically, BGI patients were 67% less likely than TE patients to fail (odds ratio 0.33, 95% CI 0.091-0.96) and 73% less likely than AGV patients to fail (odds ratio 0.27, 95% CI 0.087-0.85) overall.

Conclusions : While there was no difference in mean IOP reduction between TE, AGV and BGI, there was a lower rate of failure (as defined above) in the BGI group compared to other groups. The AGV group had the lowest, and the TE group had the highest, rate of postoperative hypotony.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

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