Comorbidities do not increase failure rates of pediatric glaucoma drainage devices
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Pediatric patients with comorbidities did not experience higher rates of glaucoma drainage device implantation failure or complications, according to a speaker at the virtual Association for Research in Vision and Ophthalmology meeting.
“Neither comorbidities nor the number of implanted tubes were significantly associated with failure or complication. Patients with comorbid conditions appear to have better outcomes than one may expect,” Charles M. Medert, MD, said.
Medert and colleagues evaluated pediatric glaucoma drainage devices (GDD) implanted between May 1997 and July 2019 at Bascom Palmer Eye Institute. One hundred fifty primary tubes and 22 second tubes were identified. The researchers evaluated the association between existing patient comorbidities and GDD implantation failures and complications.
Medert said a failure was defined by IOP greater than 21 mm Hg, a reduction of IOP by less than 20% or IOP less than 5 mm Hg at 3 months after implantation, as well as the need for reoperation for glaucoma and loss of light perception vision. Complications were defined as postoperative events attributed to the GDD requiring surgical intervention or unplanned examination under anesthesia.
Comorbid conditions were defined as any systemic or ocular disease/syndrome with known ocular sequela, he said.
In total, 50.7% of first-time tube patients had no comorbidities. The researchers found no association between those with comorbidities and development of a complication. Similarly, no association was found with an increased risk for developing a failure, Medert said. The most common comorbidity was juvenile idiopathic arthritis, occurring in 6% of patients.
Nine of the second-time tube patients (40.9%) had no comorbidity. Similar to the first-time tube patients, the presence of a comorbidity in the second-time tube cohort did not increase the risk for developing a GDD complication or failure, Medert said.
“Additional tubes do not appear to add undue risk, which might allow the provider to feel more comfortable placing a second tube depending on the circumstances,” he said. – by Robert Linnehan
Reference:
Medert CM. Are comorbidities and tube status associated with tube failures and complications? Presented at: Association for Research in Vision and Ophthalmology annual meeting; May 6, 2020 (virtual meeting).
Disclosure: Medert reports no relevant financial disclosures.
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Medert CM. Are comorbidities and tube status associated with tube failures and complications? Presented at: Association for Research in Vision and Ophthalmology annual meeting; May 6, 2020 (virtual meeting).
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