Impact of age, corneal thickness, intraocular pressure, and preoperative use of topical carbonic anhydrase inhibitors on rates of corneal decompensation requiring corneal graft in patients with Ahmed or Baerveldt implants.

Theme: Glaucoma
What: Glaucoma
Part of: Glaucoma I: Medical / Glaucome I: Médical
When: 5/31/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 801

Abstract

Purpose: 

To study the impact of age at first valve implantation, corneal thickness, intraocular pressure, and preoperative use of topical carbonic anhydrase inhibitors on rates of corneal decompensation requiring corneal graft in patients with Ahmed or Baerveldt glaucoma drainage devices in a tertiary-care center.

Study design: 

Retrospective cohort study. 

Methods: 

All patients operated with a glaucoma drainage device at the CHU de Québec – Université Laval between 2000 and 2021 were considered for inclusion. Patients lost to follow-up before 6 months were excluded. The primary outcomes included the impact of age at first valve implantation, corneal thickness, intraocular pressure, and use of topical carbonic anhydrase inhibitors preoperatively on the incidence of corneal decompensation requiring corneal graft. 

Results: 

Of the total initial 914 eyes, 865 were included in the analysis. Median [Q1, Q3] age at first implantation was 68 [58, 76] years and median [Q1, Q3] maximum IOP was 31 [25, 38]mm Hg. Median [Q1, Q3] BCVA was 0.34 [0.14, 0.67]. Median [Q1, Q3] pachymetry was 538 [510, 571] um. In the period leading to implantation, 81% of the eyes had prostaglandin analogs, 80% had carbonic anhydrase inhibitors, 77% had beta-blockers, 57% had alpha-receptor agonists, and 8% had pilocarpine. Median [Q1, Q3] follow-up duration was 52 [21, 97] months (4 years).  At follow-up, a total of 95 (11%) patients required a corneal graft. There were no significant differences in relation to age (p=0.15) and preoperative pachymetry (p=0.36) in the need for corneal graft, nor were there significant differences in the type of topical glaucoma drops used preoperatively (p>0.05). There were significant differences in relation to preoperative IOP between the grafted group 24 mm Hg [17, 30] and the non-grafted group 20 mm Hg [15, 28] (p=0.006).

 

Conclusion: 

Patients with a higher preoperative IOP had higher rates of corneal decompensation requiring corneal grafts.

 

 

Presenter(s)

Presenting Author: Rayan Tolba

Additional Author(s):

Aaron Xu, Université Laval

Laurence Bussières, Université Laval

Mélanie Hébert, Université Laval

Caroline Lajoie, Université Laval

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