Abstract
Purpose :
To report a series of cases with glaucoma drainage tube exposure and evaluate the possible risk factors for tube exposure in resident performed glaucoma drainage implant surgery.
Methods :
The medical records of all patients at the Queens Hospital Center - NYC Health + Hospitals who underwent Ahmed or Baerveldt glaucoma implant surgery by resident physicians from August 1, 2015 to November 1, 2020 were reviewed. Patients who presented with glaucoma drainage tube exposure and required surgical revision of the tube were identified. Demographic factors, past ocular history, past medical history, current treatment, and time to exposure were abstracted from the identified charts and were compared with a similar number of patients without tube exposure identified during the same period.
Results :
Five patients (7 eyes) experienced glaucoma drainage tube exposure. The average time to exposure was 46.7 ± 33.6 months. The exposure group had similar mean age of 67.1 ± 11.8 compared to the non-exposure group’s mean age of 66.7 ± 15.4 (P=0.961). More males 57.1% and fewer African-Americans 42.9% were identified in the exposure group versus 14.3% male and 85.7% African-American in the non-exposure group. All the patients in the exposure group had a diagnosis of primary open angle glaucoma (POAG). In the non-exposure group, four patients had POAG, one had chronic angle closure glaucoma, one had neovascular glaucoma, and one had uveitic glaucoma. In the non-exposure group, all the tubes were located superiorly while in the exposure group 71.4% of the tubes were in the inferior quadrant. The number of previous glaucoma surgeries was significantly higher (P=0.018) in the exposure group (2.57 ± 1.51) compared with the non-exposure group (0.57 ± 0.54). The number of intraocular pressure lowering eye drops was higher (P=0.052) in the exposure group (3.29 ± 1.11) compared with the non-exposure group (1.71 ± 0.76).
Conclusions :
Inferior location of the glaucoma drainage tube, previous glaucoma surgery, and the number of intraocular pressure lowering eye drops are potential risk factors for tube exposure in resident performed glaucoma drainage implant surgery.
This is a 2021 ARVO Annual Meeting abstract.