The Long-term Outcomes of Glaucoma Drainage Device in Pediatric Glaucoma.

PURPOSE

To evaluate the long-term outcomes and safety of glaucoma drainage device (GDD) in pediatric patients.

METHODS

Retrospective, noncomparative study including all patients below 18 years old who underwent Baerveldt or Molteno GDD implantation by a single surgeon. Mitomycin-C was used in most cases. Success was defined as postoperative intraocular pressure (IOP) between 6 and 22 mm Hg and a 20% reduction in IOP.

RESULTS

Sixty-nine eyes of 52 patients were analyzed. Mean follow-up length was 45.7±25.2 months (range, 6 to 101 mo). At last postoperative visit, mean IOP and median number of antiglaucoma medications had been significantly reduced from baseline. Cumulative probability of qualified success was 95.6% at 1 year and declined to 71.3% at 5 years and 39.7% at 8 years. Multivariate analysis showed that non-white patients and previous history of cyclophotocoagulation had higher risks of failure at 5 years. Hypotony was the most common complication (39.1%) in the first 6 months postoperatively. Bleb encapsulation occurred in 16.4% of patients. Endophthalmitis occurred in 5.8% of cases and necessitated removal of the GDD.

CONCLUSIONS

GDD surgery can work adequately in children in the long term. A relatively high complications rate should be expected, but in most cases these can be managed successfully. Early recognition of complications is necessary to ensure a good outcome.