Abstract
Purpose: :
To investigate if previous cyclodestructive (e.g. cyclophotocoagulation and cyclocryodestruction) procedures have any influence on the general outcome and pressure level after glaucoma drainage device (GDD) surgery.
Methods: :
Retrospective analysis of 110 consecutive patients who had undergone glaucoma drainage device (Baerveldt 250 mm2 & 350 mm2 implant, AMO, USA) surgery between March 2006 and January 2010 in our departement and had a follow-up of 3 or more months. The patients were divided into patients with previous cyclodestructive surgery before GDD surgery (I; 47 patients) and patients without previous cyclodestructive surgery before (II; 64 patients). Intraocular pressure (IOP), medication score, best corrected visual acuity and surgical treatments were recorded before and after drainage device implantation.
Results: :
Patients of group I had a mean preoperative IOP of 32.1 mmHg and a mean medication score of 4.8; patients of group II had a mean preoperative IOP of 29.3 mmHg (p = 0.16) and a mean medication score of 4.9 (p = 0.85). All patients who developed suprachoroidal hemorrhage (six cases) belonged to group I (6/47 = 12.8 %), no patient of group II (0/63 = 0 %) developed suprachoroidal hemorrhage (p = 0.003). Twelve patients developed late-onset (> 6 weeks after GDD surgery) hypotony, nine of them belonging to group I (9/47 = 19.1 %) and three of them belonging to group II (3/63 = 4.8 %) (p = 0.02).
Conclusions: :
Although selection bias owing to retrospective study design should be considered, a history of previous cyclodestructive procedures before GDD surgery seems to be a risk factor for suprachoroidal hemorrhage and for late-onset postoperative hypotony.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: risk factor assessment