Abstract
Purpose :
To assess the effectiveness of glaucoma drainage device (GDD) implant after failed trabectome.
Methods :
Retrospective chart review of GDD implantation after failed trabectome during 2013-2019. Outcome measures were intraocular pressure (IOP), number of IOP-lowering medications and surgical complications at 12 months after GDD. Unpaired t-test was used for statistical analysis.
Results :
Fifteen eyes were included. The interval time between trabectome and GDD ranged from 1 to 32 months (15.4±10.1). The average IOP was 26.7±8.5mmHg with 2.9±0.7 medications prior to trabectome, and 28.9±8.8 with 3.3±0.80 medications prior to GDD (pre-GDD). After GDD surgery, average IOP was reduced to 14.1±5.0mmHg (p=<0.00001) with 2.1±1.6 medications (p=0.0069 vs pre-GDD) at the 12-month visit. No major surgical complications were documented for either trabectome or GDD surgery.
Conclusions :
Trabectome surgery has been found effective in treating open angle glaucoma,1 Studies assessing the effectiveness of trabectome during GDD and after failed GDD have also shown significant reductions in IOP.2,3 However, some eyes may fail to respond to the primary trabectome surgery. It is unclear if these eyes would respond to sequential GDD. Our data indicated placement of a GDD after failed trabectome still resulted in significantly reduced IOP and medication usage without major surgical complications.
References:
Avar, M., Jordan, J., Neuburger, M., et al. Long-term follow-up of intraocular pressure and pressure-lowering medication in patients after ab-interno trabeculectomy with the trabectome. Graefes Arch Clin Exp Ophthalmol. 2019; 257: 997-1003.
Esfandiari, H., Shazly, T., Shah, P., et al. Impact of same-session trabectome surgery on Ahmed glaucoma value outcomes. Graefes Arch Clin Exp Ophthalmol. 2018; 256: 1509-1515.
Mosaed, S., Chak, G., Haider, A., et al. Results of Trabectome Surgery Following Failed Glaucoma Tube Shunt Implantation: Cohort Study. Medicine (Baltimore). 2015; 94: e1045.
This is a 2020 ARVO Annual Meeting abstract.