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Gabriela Juliana Trabal, Jose Eduardo Fossas, Marino Blasini; Incidence of Conjunctival Complications in patients with Glaucoma Drainage Devices in Puerto Rico. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2077.
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To determine the incidence of conjunctival thinning or erosion after glaucoma drainage devices (GDD) surgery in patients with pericardial graft over the tube vs tubes inserted via scleral tunnel technique in the University of Puerto Rico Medical Center (UPR-MC). We conducted a retrospective analysis of electronic medical records (EMR) to identify patients and calculate absolute risk for developing complications between these surgical techniques in Puerto Rican patients.
We identified all patients at the UPR-MC who underwent GDD surgery since January 1st 2014 with follow up of more than 6 months. EMR chart review included demographic information, previous topical medications, previous ocular procedures, incidence of conjunctival thinning, incidence of conjunctival erosion, and time of follow up. Operation reports of these patients were reviewed where type of GDD, position of GDD, location of conjunctival flap, and surgical technique was documented.
A total of forty eyes were included in our study. Thirty eyes had a pericardial graft over the tube and 10 were inserted by scleral tunnel. All tubes were placed in the superotemporal quadrant. Seven out of the 30 eyes (16.6%) who had pericardial graft suffered conjunctival complications. Five eyes had conjunctival thinning and two had conjunctival erosion needing surgical repair. No eyes in the scleral tunnel technique group had conjunctival complications. Absolute risk of developing conjunctival complications in GDD with pericardial patch was 23.3% and 0% in those inserted by scleral tunnel technique.
The insertion of the GDD tube by scleral tunnel technique proved to be superior, without any conjunctival complications reported. It must be noted that the difference in the quantity of patients is much larger in the pericardial graft group. Although it is a relatively new technique used in the UPR-MC, inserting GDD tubes via scleral tunnel is currently demonstrating to be the optimal surgical technique to prevent conjunctival complications. Longer follow up will be needed in order to identify other complications that occur in these patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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