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Long-term IOP control maintained with tube surgery in uveitic eyes

Issue: April 25, 2019

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Jessica L. Cao

SAN FRANCISCO — Glaucoma drainage implants maintain long-term control of IOP in uveitic eyes with fluocinolone acetonide implants, according to a poster presented at the American Glaucoma Society annual meeting.

Jessica L. Cao, MD, of Cole Eye Institute, Cleveland Clinic, and colleagues conducted a retrospective chart review of 56 eyes of 37 patients who had received Retisert (fluocinolone acetonide intravitreal implant, Bausch + Lomb) and had undergone glaucoma drainage implant surgery at the Cleveland Clinic between 2001 and 2017.

Primary outcomes were IOP, visual acuity, number of IOP-lowering medications and complications suffered up to 10 years after surgery. Surgical success was deemed to be IOP between 6 mm Hg and 21 mm Hg at the most recent visit without need for implant removal, additional glaucoma surgeries or loss of light perception.

“We know that patients who have these inserts put in, about 70% of them end up having steroid-response glaucoma, and because of that, about 40% of them will need some sort of glaucoma surgery,” Cao told Healio.com/OSN. “Our main purpose was to see how long the tube surgeries can last in patients who do get these Retiserts.”

At 5 years, the success rate was 85% to 86%, Cao said. The most common complication was hypotony, with three persistent cases deemed to be failed tube surgeries.

“Over 10 years, we saw IOP decrease from an average of about 28 mm Hg to about 13 mm Hg, the number of medications from about three to four to one or fewer, and there is no change in visual acuity,” Cao said. “We are fortunate to be able to look at eyes that are 10 years out, and even then, those eyes do really well.” – by Patricia Nale, ELS

Reference:

Cao JL, et al. Long-term outcomes of glaucoma tube shunt surgeries in uveitic eyes with fluocinolone acetonide implants. Presented at: American Glaucoma Society annual meeting; March 14-17, 2019; San Francisco.

Disclosure: Cao reports no relevant financial disclosures.