Second Glaucoma Drainage Devices in Refractory Pediatric Glaucoma: Failure by Fibrovascular Ingrowth

Tung, Irene T.; Marcus, Inna; Thiamthat, Warakorn; Freedman, Sharon F.

doi:10.1016/j.ajo.2014.03.017

Cited by 21 publications

(9 citation statements)

References 10 publications

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“…In our study age, gender, laterality of studied eyes, preoperative IOPs, preoperative number of medications and glaucoma type of individual patients did not differ significantly between success and failure groups of patients (results of t -test and Fisher's exact test not shown here). Smith et al[ 12 ] in a retrospective study with 21 participants showed that patients with preoperative IOP ≥21 mm Hg benefited more from second AGV implantation than those with lower IOPs but in our study we did not found a significant difference in this regard.…”

Section: Discussioncontrasting

confidence: 93%

“…But a comparison of the overall success rate in these case series is not literally feasible not only because of different mix of glaucoma types studied, various lengths of follow-up and different definitions of surgical success; but even more notably because these studies are all relatively small in sample size and consequently a relatively wide confidence interval straddles their point estimates of surgical success. Smith et al[ 12 ] evaluated patients who had undergone 2 glaucoma drainage device surgeries (exclusively AGV) in a retrospective case series and found 84.2% overall success (comparable with success definition of our study according to criterion 1) in a follow-up of at least 1 year. The reported success rate was apparently more than that of the present study (75%).…”

Section: Discussionsupporting

confidence: 86%

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Evaluation of success after second Ahmed glaucoma valve implantation

Nilforushan

Yadgari

Jazayeri

et al. 2016

Indian J Ophthalmol

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Purpose:To evaluate the outcome of the second Ahmed glaucoma valve (AGV) surgery in eyes with failed previous AGV surgery.Design:Retrospective case series.Patients and Methods:Following chart review, 36 eyes of 34 patients with second AGV implantation were enrolled in this study. The primary outcome measure was surgical success defined in terms of intraocular pressure (IOP) control using two criteria: Success was defined as IOP ≤21 mmHg (criterion 1) and IOP ≤16 mmHg (criterion 2), with at least 20% reduction in IOP, either with no medication (complete success) or with no more than two medications (qualified success). Kaplan–Meier survival analysis was used to determine the probability of surgical success.Results:The average age of the patients was 32.7 years (range 4–65), and the mean duration of follow-up was 21.4 months (range 6–96). Preoperatively, the mean IOP was 26.94 mmHg (standard deviation [SD] 7.03), and the patients were using 2.8 glaucoma medications on average (SD 0.9). The mean IOP decreased significantly to 13.28 mmHg (SD 3.59) at the last postoperative visit (P = 0.00) while the patients needed even fewer glaucoma medications on average (1.4 ± 1.1, P = 0.00). Surgical success of second glaucoma drainage devices (Kaplan–Meier analysis), according to criterion 1, at 6, 12, 18, and 42 months was 94%, 85%, 80%, and 53% respectively, and according to criterion 2, was 94%, 85%, 75%, and 45%, respectively.Conclusion:Repeated AGV implantation seems to be a safe modality of treatment with acceptable success rate in cases with failed previous AGV surgery.

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Section: Discussioncontrasting

confidence: 93%

Section: Discussionsupporting

confidence: 86%

Evaluation of success after second Ahmed glaucoma valve implantation

Nilforushan

Yadgari

Jazayeri

et al. 2016

Indian J Ophthalmol

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“…More recently, Tung et al 16 evaluated the outcome of a subsequent GDD in those with refractive paediatric glaucoma. Failure of this second tube occurred at a mean of 26.1±32.3 in 42% of eyes.…”

Section: Discussionmentioning

confidence: 99%

Failed glaucoma drainage implant: long-term outcomes of a second glaucoma drainage device versus cyclophotocoagulation

et al. 2015

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“…8,[14][15][16][17] Recently, a study on sequential GDI in pediatric patients demonstrated failure rates up to 50% at 3 years of followup due to fibrovascular ingrowth. 18 To the best of our knowledge, the present study is the largest study to date assessing the efficacy and complications of eyes in consecutive patients that have undergone a second GDI for refractory glaucoma.…”

mentioning

confidence: 96%