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Sequential implant in glaucoma refractory cases lowers IOP, reduces medication
Am J Ophthalmol. 2009;149(1):95-101.
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Mean IOP and number of medications were lower in refractory glaucoma patients after a second implantation of a glaucoma drainage device, a study found.
"Sequential glaucoma implants have a good mid-term outcome and provide an effective and relatively safe means of treating inadequately controlled IOP following primary aqueous shunt," researchers said.
The retrospective observational cohort study looked at 43 eyes of 43 refractory glaucoma patients who underwent a second glaucoma implant surgery. Twenty-four eyes were implanted with a Baerveldt implant, 17 eyes received an Ahmed valve, and two eyes received a Molteno implant.
Success was IOP of 21 mm Hg or less (criterion 1) and IOP of 17 mm Hg or less at a reduction of at least 25% in IOP (criterion 2). Prolonged hypotony could not occur.
Follow up was a mean of 32.6 ± 21.6 months.
For criterion 1, subjects' success rate at 1 year was 93%; at 2 years, 89%; and at 3 years, 83%. For criterion 2, the success rate at 1 year was 83%; at 2 years, 75%; and at 3 years, 75%.