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
Shields Classification
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.
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.
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.
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.
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.
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