Abstract
Purpose :
To compare transscleral CPC and AGV for treatment of NVG
Methods :
A retrospective chart review of eyes with NVG treated with CPC or AGV implantation from 1/2017-9/2019 with >3 months follow up. Primary outcome measure was meeting failure criteria, defined as: additional glaucoma surgery, progression to no light perception (NLP) visual acuity (VA) or intraocular pressure (IOP) >21 or <6 on 2 consecutive visits after 3 months. Secondary outcome measures included change in VA, IOP & number of glaucoma medications (#GMs). Pre-op IOP was mean IOP from 2 visits pre-op. A subgroup analysis removed eyes with a pre-op VA of NLP. Alpha=0.05, significance was determined by T- or Fisher’s exact tests. Data is expressed as mean, 95% confidence interval or as a percentage.
Results :
45 eyes of 43 subjects were included, 25 eyes underwent CPC and 20 eyes underwent AGV implantation. Baseline age, sex, etiology of NVG, laterality, lens status, #GMs prescribed and follow up duration were similar in each group (P>0.05 for all). Compared to the AGV group, the CPC group had significantly worse baseline VA (logMAR 2.5 [approximately light perception], 2.2-2.7; logMAR 1.7 [approximately count fingers], 1.5-1.9; P=3.8E-5), a significantly higher cup to disc ratio (0.88, 0.78-0.98; 0.62, 0.48-0.76; P=0.0074), and a significantly higher baseline IOP (42, 39-46; 36, 33-39; P=0.016), respectively. Failure rate was similar after CPC (52%) and AGV (50%), P=1.0. Mean days to failure were also similar after CPC (192, 73-311) and AGV (150, 101-199), P=0.57. At 1-month post-op, eyes after AGV implantation were taken off significantly more #GMs (2.7, 3.4-2.0) than eyes after CPC (0.79, 1.7--0.09), P=1.8E-3. Otherwise, there were no significant differences in the changes in VA, IOP, or #GMs at any post-op interval or at final visit (P>0.05 for all). Adverse reactions (ARs) after CPC included 1 eye with hyphema. ARs after AGV included 4 eyes with hyphema; 1 with hyphema, choroidal detachment (CD) and enucleation; 1 with hyphema, tube exposure and removal; and 1 with CD. 12 eyes had a pre-op VA of NLP, all from the CPC group. When these eyes were excluded, all baseline characteristics and primary and secondary outcome measures past month one were similar (P>0.05) between the CPC and AGV groups.
Conclusions :
Refractory NVG can be treated by either CPC or AGV surgery with similar success rates and outcomes.
This is a 2020 ARVO Annual Meeting abstract.