June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Long-term clinical outcomes of pars plana (PP) versus anterior chamber (AC) placement of glaucoma tube implants
Author Affiliations & Notes
  • Vivian Qin
    Case Western Reserve University School of Medicine, Cleveland Heights, Ohio, United States
  • Mona A Kaleem
    University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Edward J Rockwood
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Annapurna Singh
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Shalini Sood-Mendiratta
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Jonathan E Sears
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Swathi Trace
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Fabiana Queiroga de Paula Araujo Silva
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Jonathan Eisengart
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Rishi P Singh
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Vivian Qin, None; Mona Kaleem, None; Edward Rockwood, None; Annapurna Singh, None; Shalini Sood-Mendiratta, None; Jonathan Sears, None; Swathi Trace, None; Fabiana Silva, None; Jonathan Eisengart, None; Rishi Singh, Alcon (F), Apellis (F), Genentech (C), Genentech (F), Optos (C), Regeneron (C), Regeneron (F), Shire (C), Zeiss (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4961. doi:
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      Vivian Qin, Mona A Kaleem, Edward J Rockwood, Annapurna Singh, Shalini Sood-Mendiratta, Jonathan E Sears, Swathi Trace, Fabiana Queiroga de Paula Araujo Silva, Jonathan Eisengart, Rishi P Singh; Long-term clinical outcomes of pars plana (PP) versus anterior chamber (AC) placement of glaucoma tube implants. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4961.

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

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Abstract

Purpose : To compare long term surgical outcomes and complications of pars plana (PP) tube implantation with conventional anterior chamber (AC) tube implantation.

Methods : Records of patients undergoing glaucoma tube shunt surgery at a single institution between 2007-2015 were retrospectively reviewed. Eyes were matched on primary glaucoma diagnosis and patient age. Only eyes with more than 12 months of follow-up data were included. Demographics and baseline characteristics as well as treatment outcomes were recorded.

Results : Sixty-four eyes that underwent PP glaucoma tube placement were compared against 64 eyes that underwent AC tube placement with either an Ahmed (82.8% in the PP group and 76.6% in the AC group) or a Baerveldt implant (17.2% in the PP group and 21.9% in the AC group). Mean follow-up was 43.3 + 24.0 months for the PP group and 35.4 + 16.8 months for the AC group (p=0.03). Preoperative mean IOP was 28.0 + 12.0 mmHg in the PP group and 32.8 mmHg + 12.4 mmHg in the AC group (p=0.04). Preoperative mean number of glaucoma medications was 2.9 + 1.0 in the PP group and 2.7 + 0.7 in the AC group (p=0.30). At all postoperative time points, the mean IOP and mean number of medications did not differ significantly between groups. Postoperative mean IOP in the PP group was 16.0, 16.0, 14.9, 19.0, and 18.0, and in the AC group was 16.0, 16.0, 17.0, 15.0, and 18.0, at the 12-, 24-, 36-, 48-, and 60-month follow-up, respectively (p>0.05 at all time points). Surgical success was defined as an IOP between 6 and 21 mmHg, no additional glaucoma surgeries performed, and at least light perception vision. Success rates at latest follow-up were similar between groups, with 85.9% success in the PP group and 81.3% success in the AC group. In the PP group, 8 eyes underwent a subsequent glaucoma surgery and 1 eye did not reach the therapeutic IOP range. In the AC group, 11 eyes underwent a subsequent glaucoma surgery and 1 eye did not reach the therapeutic IOP range despite undergoing subsequent glaucoma surgery. In the PP group, there were 19 adverse events (10 diplopia, 6 hypotony, 2 vitreous hemorrhage, 1 tube erosion). In the AC group there were 17 adverse events (7 hypotony, 4 vitreous hemorrhage, 3 diplopia, 3 corneal decompensation).

Conclusions : Long-term PP placement of glaucoma tube shunts continues to control IOP and yields similar rates of surgical success to conventional AC placement.

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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