Purpose To study the surgical outcomes of glaucoma drainage device (GDD) implantation in refractory glaucoma patients. Patients and Methods Retrospective chart review of glaucoma patients undergoing GDD implantation, Ahmed glaucoma valve (AGV), Baerveldt glaucoma implants (BGI), and Aurolab aqueous drainage implantation (AADI) from January 2012 to June 2021. Glaucoma patients were classified into two groups: primary glaucoma including: primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG) and juvenile open angle glaucoma (JOAG) and secondary glaucoma including: neovascular glaucoma (NVG), ocular surgery (vitreoretinal surgery, scleral buckling procedure, postoperative extra capsular cataract extraction, scleral fixation intraocular lens, penetrating keratoplasty), intraocular trauma, uveitis glaucoma, lens-induced glaucoma, pseudoexfoliation glaucoma (PXG), iridocorneal endothelial (ICE) syndromes and Axenfeld Rieger Syndrome. Surgical outcomes were studied. Results Primary glaucoma included 57 eyes from 49 patients. Secondary glaucoma included 87 eyes from 85 patients. The cumulative probability of complete or qualified success of refractory glaucoma patients at five years were 53.4% (95%CI: 38.4%, 66.3%). Higher success rate was discovered in primary glaucoma at 65.8% (95%CI: 38.4%, 83.3%) than 45.2% (95%CI: 26.9%, 61.9%) in secondary glaucoma group significantly with p =0.003. While the results among success rate, adverse events and complications was not different between types of GDD. Predictors for failure were neovascular glaucoma with unadjusted hazard ratio (HR) 3.62 (95%CI: 1.45, 9.04) with p =0.006, and lens-induced glaucoma with adjusted HR 4.19 (95%CI: 1.10, 15.86) with p =0.035 in multivariable analysis. Tube malposition and occlusion were the most frequent adverse events at 11.11%, corneal decompensation at 5.5%, hypotony at 2% in the nonvalved group, and endophthalmitis at 0.69%. Conclusion Surgical success in refractory primary glaucoma was superior to secondary glaucoma with no difference between nonvalved and valved GDD implantation. Lens-induced glaucoma was a strong predictor for failure in GDD implantation.

Background The literature suggests that the coronavirus disease 2019 (COVID-19) pandemic has affected rhegmatogenous retinal detachment (RRD) treatment. We determined the impact of the COVID-19 pandemic on the number, clinical characteristics, type of surgical procedure, and anatomical outcome of primary RRD during and after lockdown compared with those parameters in the same periods in the previous year. Methods In Thailand, the first lockdown was from 3 April to 30 June 2020 (89 days). We evaluated data from an equal number of days in four periods. The medical records of patients with primary RRD who underwent retinal surgery at Mettapracharak Hospital during and after the first lockdown in 2020 and the corresponding period in 2019 were reviewed. The following data were analyzed: age, sex, laterality, lens status, symptom duration, best corrected visual acuity (BCVA), macular status, number of quadrants detached, type of surgical procedure, and outcome. Results A total of 455 patients (455 eyes) underwent surgery for primary RRD. A total of 107 patients were treated during lockdown, 106 patients after lockdown, whereas 117 patients and 125 patients were treated in identical periods in the previous year, respectively. A decrease of 8.5% of RRD cases during lockdown and of 15.2% of RRD cases post-lockdown compared with those in the equivalent periods in the previous year were documented. No significant differences were found with respect to demographic features, clinical characteristics, type of surgical procedure, or the anatomical outcome of RRD patients among all time periods. However, a significantly lower prevalence of right-eye involvement and shorter waiting time for surgery after lockdown compared with those in the corresponding periods in 2019 were documented. The overall prevalence of success after a single surgical procedure was 85.3%. Conclusions We revealed the impact of the COVID-19 pandemic on the reduction in the number of surgical procedures for primary RRD during and after lockdown. Our findings could aid redefinition of a strategic plan for RRD management after the COVID-19 pandemic has subsided. Trial registration: COA014/2564; 28 October 2021