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Nur Cardakli, David S Friedman; Unplanned Return to Operating Room after Glaucoma Surgery. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3758. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine rates and reasons for unplanned return to operating room (OR) for trabeculectomy and tube shunt surgeries performed by attending surgeons at an academic glaucoma service.
Retrospective chart review of 1,241 eyes (1,241 individuals) that underwent trabeculectomy or tube shunt surgery by a fellow or attending surgeon at the Wilmer Eye Institute between January 2014-December 2016. Rate of unplanned return to OR was determined for trabeculectomy and tube shunt within the first 30, 90, or 180 days, as well as at any time during the post-operative follow-up period.
884 trabeculectomies were performed during the study period; the reoperation rate within the first 180 days was 9.5% (84/884). Mean post-operative follow-up was 2.8±1 years, and 22.9% required reoperation at some point during follow-up (202/884). The most common reoperations within 180 days were bleb revision (42.9%), bleb needling (33.3%), and choroidal drainage (22.6%); the most common reoperations at any point in the post-operative period were bleb needling (41.6%), bleb revision (30.7%), and a new IOP-lowering procedure (21.3%). 357 tube shunts were performed during the study period; 40 (11.2%) were reoperated within the first 180 days and 73 (20.4%) were reoperated at any point during follow-up (mean follow-up was 2.6±1.1 years). The most common reoperations within 180 days were tube revision (50.0%), new IOP-lowering procedure (25.0%), and vitrectomy (15.0%); the most common reoperations at any point in the post-operative period were a new IOP-lowering procedure (47.9%), tube revision (35.6%), and tube explantation (13.7%). There was not a significant difference in the rates of reoperation for trabeculectomies and tube shunt surgeries within the first 180 days (X2=0.819, p=0.365) or during the overall follow-up (X2=0.851, p=0.356).
In this large faculty practice with multiple surgeons, over 20% of trabeculectomy and tube shunt surgeries required reoperation with a mean of slightly more than 2.5 years; rates of reoperation were similar for trabeculectomies and tube shunts.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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