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Alicia Menezes, Reena Garg; Retrospective review of anterior chamber versus pars plana placement of glaucoma drainage devices by Ophthalmology Residents. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6495.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma tube shunts have played an integral role in the management of glaucoma and are an alternative to trabeculectomy. Traditionally glaucoma drainage devices have been placed in the anterior chamber. In cases of a shallow anterior chamber, cornea disease, angle neovascularization and peripheral anterior synechiae secondary to inflammation, however, insertion of a glaucoma drainage device in the pars plana combined with pars plana vitrectomy may be indicated. The purpose of this study is to evaluate the outcomes of anterior chamber versus pars plana placement of Baerveldt and Ahmed glaucoma drainage devices performed by Resident Ophthalmologists under the supervision of an attending physician.
A retrospective study comparing eyes that underwent anterior chamber placement versus eyes that underwent pars plana placement of Baerveldt and Ahmed glaucoma drainage devices was performed. All surgeries were performed by Ophthalmology Residents at The New York Eye and Ear Infirmary under the supervision of an attending between 2014 and 2015. Patients included had a minimum of 6 months of follow up. Success was measured as IOP ≥5 mmHg or ≤21mmHg, no additional glaucoma surgeries, no loss of light perception.
Between 2014 and 2015, 32 glaucoma drainage devices (21 Ahmed and 11 Baerveldt) were placed into the anterior chamber and 15 glaucoma drainage devices (2 Ahmed and 13 Baerveldt) were placed into the pars plana by Resident Ophthalmologists under the supervision of an attending. The etiology of glaucoma included primary open angle glaucoma, neovascular glaucoma, chronic angle closure glaucoma, aphakic glaucoma, uveitic glaucoma, and congenital glaucoma. The anterior chamber group had a similar IOP reduction of 60% compared to 62% in the posterior chamber group, which was not statistically significant. The success rate was also similar between the two groups. The anterior chamber group had a 93% success rate and the posterior chamber group had a 94% success rate at 6 months follow up. The complications including hypotony, choroidals, hyphema and need for revision were similar between the two groups.
Glaucoma drainage devices placed in the pars plana and the anterior chamber are both effective treatments of advanced glaucoma in residency programs with similar outcomes and complications.
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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