Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg
Background. This retrospective review reports on patients who underwent glaucoma drainage implant (GDI) surgery and had baseline intraocular pressure (IOP) of ≤18 mmHg with at least one year of follow-up. Methods. Clinical data of 67 eyes of 67 patients were collected from patients’ charts, and the...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2024/6624021 |
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| author | Shahin Hallaj Jae-Chiang Wong Lauren E. Hock Natasha Nayak Kolomeyer Aakriti G. Shukla Michael J. Pro Marlene R. Moster Jonathan S. Myers Reza Razeghinejad Daniel Lee |
| author_facet | Shahin Hallaj Jae-Chiang Wong Lauren E. Hock Natasha Nayak Kolomeyer Aakriti G. Shukla Michael J. Pro Marlene R. Moster Jonathan S. Myers Reza Razeghinejad Daniel Lee |
| author_sort | Shahin Hallaj |
| collection | DOAJ |
| description | Background. This retrospective review reports on patients who underwent glaucoma drainage implant (GDI) surgery and had baseline intraocular pressure (IOP) of ≤18 mmHg with at least one year of follow-up. Methods. Clinical data of 67 eyes of 67 patients were collected from patients’ charts, and the outcomes of GDI were evaluated until 7 years. GDI failure was defined as IOP reduction of less than 20% from the baseline at two consecutive visits three months after surgery, decline to no light perception, or if additional glaucoma surgery was performed. Results. The average age was 65.9 ± 13.2 years. Most cases were male (52.2%), White (53.7%), and had primary open-angle glaucoma (62.7%). Forty-four eyes had prior glaucoma surgery (68.6%) and 46 (68.6%) had severe glaucoma. Though postoperative (postop) IOP changes were insignificant, the average postop number of medications dropped from 2.4 ± 1.4 to 1.9 ± 1.2 medications two years after surgery (p=0.0451). Postop complications (23.9%) included GDI exposure (7.5%), inflammation (4.5%), shallow anterior chamber (4.5%), and strabismus (1.5%). Hypotony was observed in 4 eyes (5.9%), none of which developed hypotony maculopathy. The cumulative one-year failure rate was 56.7%, most of which were due to failure to lower IOP. Conclusion. In patients with baseline IOP ≤18 mmHg who had GDI surgery, though the change in IOP was not statistically significant, the number of medications dropped and visual field progression slowed in a subset of patients with adequate perimetric data. Due to a relatively high rate of complications and limited effectiveness in lowering IOP, GDI should be cautiously used in these eyes. |
| format | Article |
| id | doaj-art-d6ce7bda4b3d46a589f3e1b0794c254d |
| institution | Kabale University |
| issn | 2090-0058 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-d6ce7bda4b3d46a589f3e1b0794c254d2025-02-03T05:57:04ZengWileyJournal of Ophthalmology2090-00582024-01-01202410.1155/2024/6624021Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHgShahin Hallaj0Jae-Chiang Wong1Lauren E. Hock2Natasha Nayak Kolomeyer3Aakriti G. Shukla4Michael J. Pro5Marlene R. Moster6Jonathan S. Myers7Reza Razeghinejad8Daniel Lee9Glaucoma ServiceGlaucoma ServiceGlaucoma ServiceGlaucoma ServiceGlaucoma ServiceGlaucoma ServiceGlaucoma ServiceGlaucoma ServiceGlaucoma ServiceGlaucoma ServiceBackground. This retrospective review reports on patients who underwent glaucoma drainage implant (GDI) surgery and had baseline intraocular pressure (IOP) of ≤18 mmHg with at least one year of follow-up. Methods. Clinical data of 67 eyes of 67 patients were collected from patients’ charts, and the outcomes of GDI were evaluated until 7 years. GDI failure was defined as IOP reduction of less than 20% from the baseline at two consecutive visits three months after surgery, decline to no light perception, or if additional glaucoma surgery was performed. Results. The average age was 65.9 ± 13.2 years. Most cases were male (52.2%), White (53.7%), and had primary open-angle glaucoma (62.7%). Forty-four eyes had prior glaucoma surgery (68.6%) and 46 (68.6%) had severe glaucoma. Though postoperative (postop) IOP changes were insignificant, the average postop number of medications dropped from 2.4 ± 1.4 to 1.9 ± 1.2 medications two years after surgery (p=0.0451). Postop complications (23.9%) included GDI exposure (7.5%), inflammation (4.5%), shallow anterior chamber (4.5%), and strabismus (1.5%). Hypotony was observed in 4 eyes (5.9%), none of which developed hypotony maculopathy. The cumulative one-year failure rate was 56.7%, most of which were due to failure to lower IOP. Conclusion. In patients with baseline IOP ≤18 mmHg who had GDI surgery, though the change in IOP was not statistically significant, the number of medications dropped and visual field progression slowed in a subset of patients with adequate perimetric data. Due to a relatively high rate of complications and limited effectiveness in lowering IOP, GDI should be cautiously used in these eyes.http://dx.doi.org/10.1155/2024/6624021 |
| spellingShingle | Shahin Hallaj Jae-Chiang Wong Lauren E. Hock Natasha Nayak Kolomeyer Aakriti G. Shukla Michael J. Pro Marlene R. Moster Jonathan S. Myers Reza Razeghinejad Daniel Lee Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg Journal of Ophthalmology |
| title | Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg |
| title_full | Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg |
| title_fullStr | Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg |
| title_full_unstemmed | Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg |
| title_short | Long-Term Surgical Outcomes of Glaucoma Drainage Implants in Eyes with Preoperative Intraocular Pressure Less than 19 mmHg |
| title_sort | long term surgical outcomes of glaucoma drainage implants in eyes with preoperative intraocular pressure less than 19 mmhg |
| url | http://dx.doi.org/10.1155/2024/6624021 |
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