Glaucoma Surgery SOS: Emergency Department Utilization Greater Among Younger and First-Time Surgical Glaucoma Patients.
Ophthalmol Glaucoma
; 2024 Sep 12.
Article
em En
| MEDLINE
| ID: mdl-39277172
ABSTRACT
PURPOSE:
To describe the frequency, findings, and interventions of patients' emergency department visits after all types of glaucoma surgeryDESIGN:
Retrospective cohort studySUBJECTS:
All surgical glaucoma patients between 2013 and 2021METHODS:
This single institution study collected demographics, surgery type, and surgical parameters for each patient. Subsequently, for those visiting the emergency department within 50 days of surgery, data was collected on reason for visit, findings, and ophthalmic intervention. Logistic regression models were used to determine the odds of ED visits based on multiple risk factors. MAINOUTCOME:
Postoperative presentation to EDRESULTS:
Among 9155 surgeries in 5505 patients, 5.7% had ED visits within 50 days, with 46.3% having ocular complaints. Patients with ocular diagnoses presented earlier than those without (p < 0.001). Patients who presented to the ED with an ocular diagnosis were found to be significantly younger than those who did not present (62.2 ± 18.6 vs 65.4 ± 18.0 years old, p < 0.028). Furthermore, white patients were more likely than black patients to present with an ocular diagnosis compared to a non-ocular diagnosis (OR 2.64, 95% CI 1.67-4.18, p<0.001). Patients undergoing their first glaucoma surgery had a much higher chance of presenting to the ED compared to patients who had undergone more than one surgery (OR 3.75, 95%CI 2.74 - 5.14, p < 0.001). Those who underwent traditional surgeries were more likely than patients with trabecular meshwork bypass stent (TMBS) to present to the ED with an ocular diagnosis (OR 3.02, 95% CI 1.29 - 7.08, p = 0.011). Filtering surgeries and glaucoma drainage device (GDD) revisions exhibited more vision-threatening conditions than glaucoma drainage devices (p = 0.037 and p = 0.010 respectively). Ophthalmology consultation was sought for 88.0% of ocular diagnoses. Most received medical therapy (71.0%), primarily IOP-lowering drops.CONCLUSION:
ED visits after glaucoma surgery are infrequent, yet more often seen in younger patients or those undergoing their first glaucoma surgery. TMBS, but not trabecular meshwork excision and/or Schlemm's canal dilation (TME/SCD), were less likely to present to the ED than traditional surgeries. Filtering surgeries and tube revisions presented more often with visual threatening conditions.
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Ophthalmol Glaucoma
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
Estados Unidos