A Review on Glaucoma Drainage Devices and its Complications

Gupta, Sajal; Jeria, Sandhya

doi:10.7759/cureus.29072

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…Frustrations with glaucoma medication can reinforce the decision to undergo surgery [54] and potentially underlie patients' preferences regarding the prospect of long-term liberation from glaucoma medication. However, currently only half of glaucoma drainage devices remain functional after 5 years, highlighting the importance of ongoing research into refining the biomaterials, techniques or shapes of the devices [56].…”

Section: Discussionmentioning

confidence: 99%

Patient Preferences for Long-Term Implant Care in Cochlear, Glaucoma and Cardiovascular Diseases

Schulz

Harzheim

Hübner

et al. 2023

IJERPH

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In the process of developing and implementing innovative implant technologies the consideration of patient preferences can be beneficial for patients, doctors and developers. Nevertheless, in existing literature, there is still scarce knowledge of patients’ perspectives on long-term implant care. In this study, three discrete choice experiments (DCEs) were conducted in the context of cochlear implants (CI, n = 92), glaucoma implants (GI, n = 21) and cardiovascular implants (CVI, n = 23), examining the relative importance of attributes of long-term implant care from the patients’ perspective. The participants chose between differently shaped options for implant-related care. The attributes of these care options were generated and selected based on previous literature reviews, group discussions and a diary study with patients. The choice data were analyzed via binary logit regression. In CI-DCE, the technological compatibility of the implant with newer implant models, accessories or devices from other manufacturers was highly valued by participants, whereas in GI-DCE the (in)dependency on glaucoma medication post-implantation had the greatest influence on participants’ choice behavior. In CVI-DCE, the attribute with the highest relative importance related to the means of securing long-term treatment success. In all three DCE, shared decision making was relatively important for participants. Our results emphasized the importance of an adequate transfer of technological advancements in implant care for promoting patient benefits, such as the availability of comprehensible, understandable, high-quality information about current developments. Similarly, promoting technological health literacy and further pushing the technological compatibility, durability and safety of implants are directions for future implant development in accordance with patients’ preferences. Therefore, the participation of implant wearers in the development process is encouraged.

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Section: Discussionmentioning

confidence: 99%

Patient Preferences for Long-Term Implant Care in Cochlear, Glaucoma and Cardiovascular Diseases

Schulz

Harzheim

Hübner

et al. 2023

IJERPH

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“…In contrast, the Ahmed glaucoma implant consists of three parts: a plate made of polypropylene, silicone, or polyethylene; a silicone drainage tube; and a silicon valve. As it is a valved device, it regulates the flow, preventing hypotony postoperatively ( 21 ). A total of four studies were eligible for inclusion, examining primary and secondary outcomes.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of Molteno glaucoma implants and Ahmed glaucoma valves: insights into efficacy and safety for complex glaucoma

Raja,

Bhimani,

Alim Ur Rahman

et al. 2023

Front. Ophthalmol.

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BackgroundGlaucoma is a leading cause of irreversible blindness globally and for decades, Molteno and Ahmed glaucoma implants, operating on different mechanisms, have been used to treat complicated glaucoma with varying success.ObjectiveTo assess the safety and efficacy of the Molteno glaucoma implant (MGI) versus the Ahmed glaucoma valve (AGV) in patients with complicated glaucoma.MethodsWe comprehensively searched PubMed, Google Scholar, Cochrane Library and Science Direct) from inception till July 2023 and studies comparing patients with MGI and those with AGV in patients with complicated glaucoma. The primary outcome was intra-ocular pressure reduction at different time intervals. Secondary outcomes included surgical success rate, hypertensive phase, anti-glaucoma medication (AGM) and total complications. ResultsIn this meta-analysis, four studies were included with a patient population of 257 with refractory, neovascular or advanced uncontrolled glaucoma. Postoperative intra-ocular pressure reduction did not show significant difference between the two groups (MD: -1.34, 95% CI [-2.78, 0.09]). From the secondary outcomes, surgical success rate (RR: 0.88, 95% CI [0.51,1.53]), hypertensive phase (RR: 0.74, 95% CI [0.39,1.40]) were insignificant. Postoperative anti-glaucoma medication (MD: -0.07, 95% CI [-0.79, -0.65] and total complications (RR:1.36, 95% CI [1.07, 1.72]) were significant. ConclusionNo significant difference was observed between the patients with MGI and AGV for the primary outcome. From the secondary outcome, AGV was associated with reduced anti-glaucoma medication use and significantly lowered the number of complications.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=475539, identifier CRD42023475539.

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“…Similar to the Molteno embed, this embed has several highlights. However, it differs because it uses fragile silicon [19] . In patients with uncontrollably high intraocular weight glaucoma, BGDD was effective in reducing intraocular weight [20] .…”

Section: Baerveldt Embedmentioning

confidence: 99%

Glaucoma drainage devices: Literature review

Khairunnisa,

Agustanti

2024

Int. J. Med. Ophthalmol.

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One of the leading causes of vision impairment worldwide is glaucoma. Various etiologies for this visual congestion manifest as enlarged intraocular weight (IOP) and optic neuropathy. Nevertheless, the IOP may remain normal in certain situations, such as normotensive glaucoma. Due to its dynamic character, it is essential for an early conclusion even when the degree of vision impairment is mild and cannot be corrected. In complex glaucoma situations where previous trabeculectomy failed, and treatment was not working, glaucoma waste embed operations are becoming a more and more popular option. Plans for glaucoma seepage devices (GDD) vary; they are entwined with understanding the problem and the surgeons' preferences. Following the implantation of a GDD, problems can include the breakdown of the mucosal layer, ejection, plate displacement, hypotony, and endophthalmitis. Different seepage devices are displayed in the showcase; however, some are often used and wellknown. A couple of the most widely utilized GDDs and associated difficulties will be looked at in this article. Four stand out: Ahmed, Krupin, Baerveldt, and Molteno. The GDD's rate of dissatisfaction is zero. It has been well-known in several studies that half of the GDD is still relevant after five years. Therefore, efforts to improve the biomaterials, processes, and design of the GDD are ongoing. Additionally, the surgical method is critical to the success of GDD. The kind of glaucoma is a crucial consideration when selecting a course of treatment, as it also influences the outcome of surgery.

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A Review on Glaucoma Drainage Devices and its Complications

Cited by 7 publications

References 32 publications

Patient Preferences for Long-Term Implant Care in Cochlear, Glaucoma and Cardiovascular Diseases

Patient Preferences for Long-Term Implant Care in Cochlear, Glaucoma and Cardiovascular Diseases

Meta-analysis of Molteno glaucoma implants and Ahmed glaucoma valves: insights into efficacy and safety for complex glaucoma

Glaucoma drainage devices: Literature review

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