June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Treatment Outcomes and Post-Operative Complications of Trabeculectomy and Glaucoma Drainage Device Surgery by Age
Author Affiliations & Notes
  • Michael Abendroth
    Penn State Hershey Eye Center, Penn State College of Medicine, Hershey, Pennsylvania, United States
    MacNeal Hospital, Berwyn, Illinois, United States
  • George Papachristou
    Penn State Hershey Eye Center, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Erik Lehman
    Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Christine Callahan
    Penn State Hershey Eye Center, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Michael Abendroth, None; George Papachristou, None; Erik Lehman, None; Christine Callahan, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4954. doi:
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      Michael Abendroth, George Papachristou, Erik Lehman, Christine Callahan; Treatment Outcomes and Post-Operative Complications of Trabeculectomy and Glaucoma Drainage Device Surgery by Age. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4954.

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

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Abstract

Purpose : Prior studies have compared the treatment outcomes and post-operative complications of trabeculectomy and glaucoma drainage device surgery, but to our knowledge, none have stratified these comparisons by patient age. Our study compares the outcomes and complications of trabeculectomy and glaucoma drainage device surgery by age.

Methods : This was a retrospective, consecutive case series of 142 eyes (123 patients) that had uncontrolled glaucoma on maximum tolerated medical therapy that underwent trabeculectomy with mitomycin C or glaucoma drainage device surgery. Primary outcome measures were IOP, treatment failure (IOP >21 mmHg or reduced by <20% on two consecutive follow-up visits, IOP ≤5 mmHg on two consecutive follow-up visits, reoperation for glaucoma, or loss of light perception vision), and post-operative complications, defined as non-serious (e.g. corneal edema) or serious (e.g. choroidal hemorrhage). Results were stratified into age groups of <60, 60-69, 70-79, and ≥80 and then compared using the Wilcoxen signed-rank test and Chi-square test.

Results : At one year, the median percent decrease from pre-operative IOP in the trabeculectomy and glaucoma drainage device groups was 39% vs. 56% overall (P<.001), 44% vs. 53% in the <60 age group (P=.591), 33% vs. 48% in the 60-69 age group (P=.114), 39% vs. 62% in the 70-79 age group (P<.001), and 38% vs. 57% in the ≥80 age group (P=.224), respectively. The probability of failure was 32% vs. 35% overall (P=.738), 25% vs. 49% in the <60 group (P=.269), 57% vs. 21% in the 60-69 group (P=.035), 14% vs. 26% in the 70-79 group (P=.462), and 25% vs. 40% in the ≥80 group (P=.638), respectively. The probability of non-serious complication was 43% vs. 45% overall (P=.730), 30% vs. 44% in the <60 group (P=.499), 48% vs. 39% in the 60-69 group (P=.468), 39% vs. 51% in the 70-79 group (P=.305), and 50% vs. 50% in the ≥80 group (P=1.000), respectively. The probability of serious complication was 37% vs. 39% overall (P=.819), 70% vs. 35% in the <60 group (P=.075), 35% vs. 22% in the 60-69 group (P=.268), 27% vs. 56% in the 70-79 group (P=.019), and 38% vs. 50% in the ≥80 group (P=.444), respectively.

Conclusions : Glaucoma drainage device surgery was more effective than trabeculectomy overall and for each age group. There were no significant differences in the probabilities of failure or non-serious or serious complications for any age group.

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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