TY - JOUR
T1 - Sequential Glaucoma Implants in Refractory Glaucoma
AU - Anand, Aashish
AU - Tello, Celso
AU - Sidoti, Paul A.
AU - Ritch, Robert
AU - Liebmann, Jeffrey M.
N1 - Funding Information:
This study was supported in part by the Corinne S. Graber Research Fund of the New York Glaucoma Research Institute, New York, New York. The authors indicate no financial conflict of interest. Involved in design of study (A.A., J.M.L.); conduct of study (A.A., C.T., P.A.S., R.R., J.M.L.); data collection (A.A.); management (A.A., J.M.L.), analysis (A.A.), and interpretation of data (A.A., C.S., P.A.S., R.R., J.M.L.); and preparation (A.A., J.M.L.), review (A.A., C.T., P.A.S., R.R., J.M.L.), and approval of manuscript (A.A., C.T., P.A.S., R.R., J.M.L.). The study was approved by the New York Eye and Ear Infirmary Institutional Review Board and followed the tenets of the Declaration of Helsinki.
PY - 2010/1
Y1 - 2010/1
N2 - Purpose: To evaluate the efficacy of a second glaucoma implant in eyes with prior glaucoma implant surgery and inadequate intraocular pressure (IOP) control. Design: Retrospective observational cohort study. Methods: Patients undergoing a second glaucoma implant surgery from 1996 to 2008 were included. Outcome measures included visual acuity, IOP, glaucoma medication use, and complications. Success was defined as IOP < 21 mm Hg (criterion 1) and IOP < 17 mm Hg (criterion 2), with at least 25% reduction in IOP and no prolonged hypotony. Results: Forty-three eyes (43 patients) had a mean follow-up of 32.6 ± 21.6 months. Life-table analysis demonstrated success rates of 93%, 89%, and 83% using criterion 1 and 83%, 75%, and 75% using criterion 2 at 1, 2, and 3 years, respectively. At last follow-up, mean IOP (13.6 ± 4.6 vs 24.7 ± 7.5 mm Hg; P < .001) and mean number of medications (1.4 ± 1.2 vs 3.9 ± 1.2; P < .001) were lower following the second implant. There was no difference in preoperative and most recent logarithm of the minimal angle of resolution (logMAR) visual acuities (0.86 ± 0.13 vs 1.1 ± 0.13; P = .07). The most frequently used second implants were similar in percentage IOP reduction (Baerveldt implant, 45 ± 19%; Ahmed valve, 40 ± 18%; P = .4). Conclusions: A second glaucoma implant may effectively lower IOP in eyes with refractory glaucoma.
AB - Purpose: To evaluate the efficacy of a second glaucoma implant in eyes with prior glaucoma implant surgery and inadequate intraocular pressure (IOP) control. Design: Retrospective observational cohort study. Methods: Patients undergoing a second glaucoma implant surgery from 1996 to 2008 were included. Outcome measures included visual acuity, IOP, glaucoma medication use, and complications. Success was defined as IOP < 21 mm Hg (criterion 1) and IOP < 17 mm Hg (criterion 2), with at least 25% reduction in IOP and no prolonged hypotony. Results: Forty-three eyes (43 patients) had a mean follow-up of 32.6 ± 21.6 months. Life-table analysis demonstrated success rates of 93%, 89%, and 83% using criterion 1 and 83%, 75%, and 75% using criterion 2 at 1, 2, and 3 years, respectively. At last follow-up, mean IOP (13.6 ± 4.6 vs 24.7 ± 7.5 mm Hg; P < .001) and mean number of medications (1.4 ± 1.2 vs 3.9 ± 1.2; P < .001) were lower following the second implant. There was no difference in preoperative and most recent logarithm of the minimal angle of resolution (logMAR) visual acuities (0.86 ± 0.13 vs 1.1 ± 0.13; P = .07). The most frequently used second implants were similar in percentage IOP reduction (Baerveldt implant, 45 ± 19%; Ahmed valve, 40 ± 18%; P = .4). Conclusions: A second glaucoma implant may effectively lower IOP in eyes with refractory glaucoma.
UR - http://www.scopus.com/inward/record.url?scp=72049090627&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2009.07.019
DO - 10.1016/j.ajo.2009.07.019
M3 - Article
C2 - 19837382
AN - SCOPUS:72049090627
SN - 0002-9394
VL - 149
SP - 95
EP - 101
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 1
ER -