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Wesam Shamseldin Shalaby, Sophia Lam, Allen Ganjei, Sonali Patel, Aakriti Garg Shukla, Natasha Nayak Kolomeyer, daniel lee, L. Jay katz, Marlene R. Moster, Jonathan S. Myers, Reza Razeghinejad; The Effect of Phacoemulsification on the Functioning Tube Shunts in Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3440.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate intraocular pressure (IOP) following phacoemulsification in eyes with prior tube shunts.
Retrospective chart review of consecutive open angle glaucoma patients with a prior tube shunt and IOP ≤ 21 mmHg, who underwent phacoemulsification and had ≥24 months of follow-up following cataract surgery. The main outcome measure was cumulative surgical failure at post-operative month 24, which was defined as IOP >21 mmHg, progression to no light perception (NLP) vision, glaucoma reoperation, or removal of the implant. Additional analysis of surgical failure defined as IOP >18 and >15 mmHg (for eyes with baseline IOP below these cutoff points) was performed. Changes in visual acuity (VA), IOP, and medications number were also assessed.
27 eyes of 27 patients with mean age of 64.2±10.8 years and 2-year follow-up duration were included. The average interval between the tube shunt and cataract surgeries was 28.8±25.0 months. All patients had moderate to severe glaucoma. At month 24, 4 (14.8%) eyes met the failure criteria, and mean time to failure was 19.3±3.8 months. Reasons for failure were high IOP in 2 (50.0%) and glaucoma reoperation in 2 (50.0%) eyes. No eyes progressed to NLP vision. Additional analyses of surgical failure defined as IOP >18 and >15 mmHg showed increasing failure rate (18.5% and 48.5%, respectively). Kaplan-Meier survival analysis showing the cumulative rate of surgical failure at 24 months using the main and alternate failure criteria is displayed in Figure 1. The mean IOP and number of glaucoma medications remained stable at month 24 compared to baseline (P=0.131 and P=0.302, respectively). VA showed initial improvement at month 6 (P=0.001), but at month 24 this improvement was not significant (P=0.430).
IOP remained controlled in most eyes with prior tube shunt surgery 2 years following phacoemulsification.
This is a 2021 ARVO Annual Meeting abstract.
Figure 1. Kaplan-Meier Survival Plot of cumulative probability of Surgical Failure in Patients with Phacoemulsification and Prior Tube Shunt Surgery. Surgical Failure was defined as intraocular pressure > 21 mmHg (A), > 18 mmHg (B), or > 15 mmHg (C).
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