Abstract
Purpose :
Micropulse transscleral cytophotocoagulation (MCPC) is a procedure that has been shown to lower IOP in patients with severe glaucoma. The efficacy of MCPC in patients who have previously received Ahmed glaucoma valves (AGV) (New World Medical, Rancho Cucamonga, CA, USA) remains unknown. We investigated long-term outcomes in eyes with AGV placement undergoing MCPC, comparing IOP and medication usage in patients who received an AGV before or concurrently with MCPC with patients who did not.
Methods :
Records from a glaucoma practice in New York City where MCPC was performed for at least 3 years were de-identified and retrospectively analyzed. Patients who had undergone MCPC with at least 1 year of follow-up were identified through billing records. Records were reviewed for demographics, IOP, medication use, visual acuity, and complications. Macular edema was confirmed with optical coherence tomography through imaging records. Main data points included intraocular pressure and concomitant eye drops. Groups were compared with 2 tailed unpaired t-tests using Microsoft Excel.
Results :
60 patients meeting inclusion criteria were identified and categorized into groups that received MCPC only (n=25), AGV prior to MCPC (n=22), or AGV and MCPC simultaneously (n=13). The average IOP prior to treatment was 26.8±9.0 mmHg and the average medication eye drop usage was 3.0±1.0. At 12 months after MCPC treatment, the average IOP was 14±7.4 mmHg (48% reduction) and average eye drop usage was 2.4±1.2 (20% reduction). In the AGV prior to MCPC group compared to the MCPC only group, there was no significant difference in IOP’s at 12 months (p=.30). The MCPC only group had significantly lower eye drop usage than the AGV prior to MCPC group at 12 months (p=.0001). There was no significant difference between IOP’s at 12 months between the simultaneous MCPC and AGV placement group and the MCPC only group (p=.18). There was no significant difference in eye drop usage at 12 months between the simultaneous MCPC and AGV placement group and the MCPC only group (p=.19).
Conclusions :
In patients with prior or simultaneous AGV placements, there were no significant differences in IOP's at 12 months compared to patients who received MCPC only. These results suggest that AGV placement prior to or concurrent with MCPC likely does not influence the efficacy of MCPC in patients with severe glaucoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.