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Published in: Japanese Journal of Ophthalmology 3/2015

01-05-2015 | Clinical Investigation

Surgical outcomes of inflammatory glaucoma: a comparison of trabeculectomy and glaucoma-drainage-device implantation

Authors: Shawn M. Iverson, Namita Bhardwaj, Wei Shi, Mitra Sehi, David S. Greenfield, Donald L. Budenz, Krishna Kishor

Published in: Japanese Journal of Ophthalmology | Issue 3/2015

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Abstract

Purpose

Our aim was to compare surgical outcomes of trabeculectomy and nonvalved glaucoma-drainage-device (GDD) implantation in eyes with chronic inflammatory glaucoma and uncontrolled intraocular pressure (IOP).

Methods

A retrospective chart review was conducted on patients with glaucomatous optic neuropathy, chronic anterior or posterior segment inflammation, and ≥6 months postoperative follow-up. All eyes underwent trabeculectomy with either antifibrotic therapy or implantation of a Baerveldt GDD (Abbott Laboratories Inc., Abbott Park, IL, USA). Failure was defined as IOP >21 mmHg, <20 % reduction below baseline or IOP <5 mmHg on two consecutive follow-up visits after 3 months, reoperation for glaucoma, or loss of light-perception vision. Statistical methods consisted of Student’s t tests, χ2 test, and Kaplan–Meier time to failure analysis.

Results

Nineteen trabeculectomies of 42 patients were followed for a mean of 31 ± 23 and 23 GDD eyes for a mean of 39 ± 19 months (P = 0.22). At last follow-up, mean IOP (11.83 ± 4.59 and 13.15 ± 6.11 mmHg, P = 0.45) and number of glaucoma medications (1.28 ± 1.56 and 1.26 ± 1.25, P = 0.97) were similar between the trabeculectomy and GDD groups. The frequency and types of postoperative complications in both groups were similar. The cumulative probability of failure after 5 years of follow-up was significantly greater in trabeculectomy eyes (62 %) compared with GDD eyes (25 %) (P = 0.006).

Conclusions

Nonvalved tube-shunt surgery was more likely to maintain IOP control and avoid reoperation than trabeculectomy with antifibrotic therapy in eyes with chronic inflammatory glaucoma.
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Metadata
Title
Surgical outcomes of inflammatory glaucoma: a comparison of trabeculectomy and glaucoma-drainage-device implantation
Authors
Shawn M. Iverson
Namita Bhardwaj
Wei Shi
Mitra Sehi
David S. Greenfield
Donald L. Budenz
Krishna Kishor
Publication date
01-05-2015
Publisher
Springer Japan
Published in
Japanese Journal of Ophthalmology / Issue 3/2015
Print ISSN: 0021-5155
Electronic ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-015-0372-6

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