The outcomes of a low-cost, non-valved glaucoma drainage device using mitomycin-C: 1-year results.
Awad-Allah Mo'mena Ahmad A, Mousa Amr Saleh, Ashour Doaa Maamoun
AI Summary
A study found a low-cost glaucoma drainage device (AADI) with mitomycin-C effectively lowered IOP in refractory glaucoma, achieving a 94% success rate at one year, offering a safe, accessible treatment option.
Abstract
Purpose
To evaluate the indications, outcomes, and complications of the usage of Aurolab Aqueous Drainage Implant (AADI) using mitomycin-C.
Methods
A retrospective case series of patients who underwent AADI placement using mitomycin-C between April 2018 and June 2020 at Ain Shams University Hospitals, Cairo, Egypt. The data was extracted from the records of the patients with a minimum of 1 year of follow-up. Complete success was defined as IOP ≥ 5 mmHg and ≤ 21 mmHg or reduction of IOP by ≥ 20% from baseline without antiglaucoma medications (AGMs). Qualified success was defined as reaching the same IOP range with the aid of AGM.
Results
A total of 50 eyes of 48 patients were included. Neovascular glaucoma represented the commonest indication (13 patients, 26%). The mean preoperative IOP was 34.0 ± 7.1 mmHg, with a median number of AGM of 3 (mean ± SD = 2.84 ± 1), while the mean IOP after 12 months was 14.3 ± 4 with a median number of AGM of 0. (mean ± SD = 0.52 ± 0.89) (p < 0.001). Complete success was achieved in 33 patients (66%). Qualified success was achieved in 14 patients (28%). Thirteen eyes (26%) had variable postoperative complications; none of them required explantation of the device or affected the visual acuity (except one patient).
Conclusion
AADI with using mitomycin-C and ripcord during the surgery is an effective and relatively safe method of control of IOP in refractory and advanced cases of glaucoma, with an overall success rate of 94%.
MeSH Terms
Shields Classification
Key Concepts6
The Aurolab Aqueous Drainage Implant (AADI) using mitomycin-C achieved a complete success rate of 66% (33 out of 50 eyes) at 12 months, defined as IOP ≥ 5 mmHg and ≤ 21 mmHg or reduction of IOP by ≥ 20% from baseline without antiglaucoma medications.
The Aurolab Aqueous Drainage Implant (AADI) using mitomycin-C achieved a qualified success rate of 28% (14 out of 50 eyes) at 12 months, defined as reaching the same IOP range (IOP ≥ 5 mmHg and ≤ 21 mmHg or reduction of IOP by ≥ 20% from baseline) with the aid of antiglaucoma medications.
The overall success rate (complete and qualified success) for the Aurolab Aqueous Drainage Implant (AADI) with mitomycin-C and ripcord during surgery was 94% in refractory and advanced cases of glaucoma.
The mean preoperative IOP for patients undergoing Aurolab Aqueous Drainage Implant (AADI) placement using mitomycin-C was 34.0 ± 7.1 mmHg, which decreased to 14.3 ± 4 mmHg after 12 months (p < 0.001).
The median number of antiglaucoma medications (AGM) for patients undergoing Aurolab Aqueous Drainage Implant (AADI) placement using mitomycin-C decreased from 3 (mean ± SD = 2.84 ± 1) preoperatively to 0 (mean ± SD = 0.52 ± 0.89) after 12 months (p < 0.001).
Postoperative complications occurred in 13 eyes (26%) following Aurolab Aqueous Drainage Implant (AADI) placement using mitomycin-C, none of which required explantation of the device or affected visual acuity (except one patient).
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