Intermediate-term outcomes of pars plana tube insertion of Aurolab aqueous drainage implant for refractory glaucoma

Abstract

PurposeTo report the safety and efficacy of parsplana tube insertion of Aurolab aqueous drainage implant(AADI) in patients with refractory glaucoma.MethodsCharts of patients with refractory glaucoma who underwent AADI via the parsplana route between June 2014 and June 2018with a minimum follow-up of 6 months were retrospectively reviewed. Success was defined as complete when the intraocular pressure (IOP) was ≥5 and18 mmHg or IOP reduction was >30%from baseline without antiglaucoma medication (AGM) andas qualified if requiring additional AGMs.ResultsThe study included 63 eyes of 63 patients with a mean age of 36.1±20.6 years and a mean follow-up of 19.7±15.7 months. Glaucoma postvitreoretinal surgery was the the most common aetiology (22 eyes, 35%). The mean IOP reduced from 36.6±10.7 mmHg to15.7±8.2 (57.1%), 15.02±7.3 (60%) and 17.2±8.5 mmHg (53%)at 6 months and 1 and 2 years, respectively. Kaplan-Meier estimates showed that the cumulative probabilities of failure were 8% (95% CI4.3% to 22.4%) at 6 months, 23% (95%CI12.8% to 38.6%) at 1 year, 30% (95%CI17.4% to 45.9%) at 18 months and 47% (95% CI13.4% to 64.9%) at the 2 years time points.Vitreous blocking tube tip was noted up to 8% of eyes on follow-up.ConclusionPars plana AADI insertion is a useful procedure for the control of IOP in patients with refractory glaucoma.

Pars plana Aurolab aqueous drainage implantation for refractory glaucoma: Outcome of a new modified technique

“…Moreover, a previous report on the pars plana placement of AADI demonstrated a slightly lower IOP reduction at 56% at 12 months. [ 27 ] Our findings were consistent with a report on AC placement of AADI, which demonstrated 60% IOP reduction at 12 months. [ 19 ] Furthermore, a report by Maheshwari et al .…”

“…Our study’s cumulative success rate at 12 months was 75%, which is comparable with 77% cumulative success at 12 months noted in a similar study of AADI in the vitreous cavity[ 27 ] and was in the lower range of 67–96% success rates previously described for AADI and Baerveldt implants. [ 20 26 33 34 ] This variation in the success may be due to a difference in the underlying severity of the disease, surgical technique, and length of follow-up.…”

“…Babu N, et al . [ 27 ] included 63 eyes and had a similar 60% IOP reduction as ours at 65%. Their cumulative probability of failure was 23% at 1 year also aligned with ours at 26.1%, and the complication rate was similar to ours (30%).…”

“…A study by Babu N et al . [ 27 ] with pars plana placement of AADI described a complication rate of 30%. The most common complications were choroidal detachment, retinal detachment, and vitreous blocking of the AADI tip.…”

“…[ 20 21 ] Although substantial published literature exists on pars plana implantation of BGI combined with Pars plana vitrectomy (PPV),[ 8 22 23 24 25 26 ] published work pertaining to AADI implantation through a pars plana approach is sparse with just two retrospective reports on this topic. [ 27 28 ] This retrospective review reports the outcomes after pars plana AADI implantation in the vitreous cavity including the reduction of intraocular pressure (IOP) and anti-glaucoma medication (AGM), as well as its associated complications and the need for additional interventions.…”