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Clin Exp OphthalmolMarch 20252 citations

Low-Cost New Glaucoma Drainage Device in Indonesia: One Year Follow-Up of 252 Subjects.

Asrory Virna Dwi Oktariana, Morgan William H


AI Summary

A new low-cost Indonesian glaucoma drainage device effectively lowered eye pressure in refractory glaucoma patients for one year, comparable to other devices, offering a promising, accessible treatment option.

Abstract

Background

To evaluate the early efficacy and safety of a new polymethyl methacrylate 200 mm 2 non-valved glaucoma drainage device (GDD) designed for Indonesian use over a 12 month period.

Methods

This was a prospective study following subjects with various forms of refractory glaucoma aged ≥ 7 years old followed for 12 months. The subjects had IOP measurements and biomicroscopy examination preoperatively and at 1, 3, 6 and 12 months timepoints. We noted anti-glaucoma medication use and additional interventions during follow-up. Success was defined as an IOP > 5 and ≤ 21 mmHg on no medications (complete) or medications (qualified).

Results

There were 252 subjects, 31% (79/252) primary glaucoma and 69% (173/252) secondary glaucoma. All primary glaucoma had previous surgery. The majority of secondary glaucoma was post-vitrectomy and silicone oil insertion 35.6% (62/174). The mean pre-op IOP was 36.8 ± 12.2 mmHg and the 12 months post op IOP was 14.2 ± 6.6 mmHg. The qualified success rate was 89% at 1 year and the complete success was 57%. Mean medication use dropped from 3.5 to 1.3. Certain subtypes (Silicone oil and POAG) appeared to experience greater IOP reduction, however they also had greater preoperative IOP.

Conclusion

This new GDD has comparable IOP lowering outcomes compared with other non-valved glaucoma drainage devices during 1 year follow up with similar complication rates.


MeSH Terms

HumansGlaucoma Drainage ImplantsIntraocular PressureIndonesiaMaleFemaleProspective StudiesFollow-Up StudiesMiddle AgedAgedAdultGlaucomaTonometry, OcularChildAdolescentYoung AdultVisual AcuityAged, 80 and overTreatment OutcomeProsthesis DesignPolymethyl Methacrylate

Key Concepts5

A new polymethyl methacrylate 200 mm2 non-valved glaucoma drainage device (GDD) designed for Indonesian use demonstrated a qualified success rate of 89% at 1 year in 252 subjects with various forms of refractory glaucoma, defined as an IOP > 5 and ≤ 21 mmHg on medications.

TreatmentCohortProspective Cohortn=252 subjectsCh41

A new polymethyl methacrylate 200 mm2 non-valved glaucoma drainage device (GDD) designed for Indonesian use achieved a complete success rate of 57% at 1 year in 252 subjects with various forms of refractory glaucoma, defined as an IOP > 5 and ≤ 21 mmHg on no medications.

TreatmentCohortProspective Cohortn=252 subjectsCh41

The mean intraocular pressure (IOP) in 252 subjects with various forms of refractory glaucoma treated with a new polymethyl methacrylate 200 mm2 non-valved glaucoma drainage device (GDD) designed for Indonesian use decreased from a pre-operative mean of 36.8 ± 12.2 mmHg to a 12-month post-operative mean of 14.2 ± 6.6 mmHg.

TreatmentCohortProspective Cohortn=252 subjectsCh3Ch41

The mean anti-glaucoma medication use in 252 subjects with various forms of refractory glaucoma treated with a new polymethyl methacrylate 200 mm2 non-valved glaucoma drainage device (GDD) designed for Indonesian use decreased from 3.5 pre-operatively to 1.3 at 12 months post-operatively.

TreatmentCohortProspective Cohortn=252 subjectsCh29Ch41

In a prospective study of 252 subjects with various forms of refractory glaucoma, 31% (79/252) had primary glaucoma, all of whom had previous surgery, and 69% (173/252) had secondary glaucoma, with the majority (35.6%, 62/174) being post-vitrectomy and silicone oil insertion.

EpidemiologyCohortProspective Cohortn=252 subjectsCh7Ch12

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