Abstract
Purpose :
This study compared the probability of visually threatening complications arising after GDD surgery over 10 years among patients with open-angle (OAG), angle-closure (ACG), neovascular (NVG), and pseudoexfoliative (PXE) glaucoma.
Methods :
Longitudinal study evaluating 382 eyes of 324 patients with OAG (n=211), ACG (n=41), NVG (n=67), or PXE (n=63) glaucoma who received a GDD between 1/1/1994 and 12/31/2018 at a single institution. Glaucoma type, GDD type, and types of visually threatening complications were recorded and analyzed. Visually threatening complications were defined as: additional glaucoma surgery, natural corneal decompensation, tube erosion, hypotony, infection, loss of light perception, and suprachoroidal hemorrhage. Main outcome measure included time to visually threatening complications after GDD among patients with OAG, ACG, NVG, or PXE glaucoma, which was analyzed by the Kaplan-Meier estimator.
Results :
64 eyes developed visually threatening complications. The most common complication was additional glaucoma surgery (35; 55%). No significant differences were noted in complications among GDD types, Baerveldt 350 (32 of 221 in study; 15%), Baerveldt 250 (8 of 51; 16%), Ahmed FP7 (15 of 78; 19%), Ahmed S2 (5 of 25; 20%), Ahmed B1 (2 of 4; 50%), or Schocket (1 of 3; 33%).
Kaplan-Meier estimate (Fig. 1) showed that the likelihood of visually threatening complications after GDD placement increased up to 5 years for the OAG and PXE groups (range 21-24% at year 5) and increased up to 10 years for the ACG and NVG groups (range 44-45% at year 10). The overall rate of visually threatening complications at 10 years was 27%. There was no statistically significant difference in the time to visually threatening complications among the 4 glaucoma types (p=0.42).
Conclusions :
For eyes with OAG, ACG, NVG, and PXE glaucoma, there was a 27% overall probability of developing visually threatening complications over a 10-year period after GDD placement. The likelihood of developing a visually threatening complication continued to increase up to 5 years for the OAG and PXE groups and up to 10 years for the ACG and NVG groups, although there was no statistically significant difference in time to complications among the four glaucoma types.
This is a 2020 ARVO Annual Meeting abstract.