ABSTRACT
Purpose: To report the outcomes of pars plana insertion of Aurolab aqueous drainage implant (AADI) in adults with refractory glaucoma by the novel technique of making scleral tunnel instead of patch graft to cover the tube to prevent its migration. Methods: A retrospective study was done between April 2016 and April 2018 on patients with ?12 months of follow?up. The main outcome measure was a surgical failure at 12 months. The failure was defined as intraocular pressure (IOP) >18 mmHg or IOP ?5 mmHg on two consecutive follow?up visits after 3 months, reoperation for glaucoma, loss of light perception vision, or implant explantation. Alternate definitions of failure including IOP >21 and IOP >15 mmHg were also considered. Results: The study included 32 eyes of 32 patients. The mean age was 46.2 ± 17.5 years. The most common etiology is traumatic glaucoma (12 eyes, 37.5%). The mean preoperative IOP and anti?glaucoma medications were 43.3 ± 10.3 and 3.4 ± 0.5 mmHg, respectively; both the parameters at the final follow?up were reduced to 15.2 ± 8.1 and 1.6 ± 0.5 mmHg. The Kaplan–Meier survival estimates demonstrated that the cumulative probability of failure was 15.6% (95% CI; 6.8–33.5%) at 3 months, 18.7% (95% CI; 8.9–37.0%) at 6 months, and 25.0% (95% CI; 13.4–43.8%) at 12 months. Conclusion: Pars plana AADI implantation with a newer modification technique is a useful procedure in reducing IOP and the number of anti?glaucoma medications in the eyes with refractory glaucoma. The visual acuity may be stabilized with the concurrent treatment of posterior segment pathology
ABSTRACT
@#AIM: To investigate and discover whether different insertion areas for Baerveldt glaucoma implant(BGI)surgery produce different outcomes in terms of the reduction of intraocular pressure(IOP). <p>METHODS: This retrospective study involved the review of cases of patients admitted at Toho University Sakura Medical Center, who underwent BGI surgery <i>via</i> the pars plana route for the treatment of neovascular glaucoma. The patients were divided into two groups: the superotemporal insertion group \〖18 eyes in 16 subjects(13 males, 3 females; mean age 62.9±14.4a)\〗 and the inferonasal insertion group \〖17 eyes in 15 subjects(11 males, 4 females; mean age 56.9±10.7a)\〗. The patients were followed up and re-evaluated at 12mo. The IOP reduction rate 12mo after surgery relative to preoperative IOP was compared between the two groups.<p>RESULTS: The mean preoperative IOP was 31.1±10.0 mmHg and postoperative IOP was 14.4±4.5 mmHg in the superotemporal group, whereas for the inferonasal group, the mean preoperative IOP was 34.9±9.7 mmHg and postoperative IOP was 15.9±3.7 mmHg. The IOP reduction rate of the superotemporal group was(50.0±19.0)% and that of the inferonasal group was(51.2±16.3)%. There was no significant correlation between the two groups(Student's<i> t</i>-test, <i>P</i>=0.590).<p>CONCLUSION: There was no difference in the short-term clinical outcomes between superotemporal and inferonasal BGI performed <i>via</i> the pars plana route.