A Retrospective Study: Effect of Glaucoma type, Pre-Implant Incisional Surgery and Lens Status on the Corneal Decompensation Rates Following a Baerveldt and Ahmed Implantation in a Tertiary-Care Center

Theme: Glaucoma
What: Glaucoma
Part of: Glaucoma II: Surgery / Glaucome II: Chirurgical
When: 5/31/2024, 02:00 PM - 03:30 PM
Where: Room | Salle 801

Abstract

Purpose: To examine the impact of glaucoma type, pre-implant incisional surgery, and lens status on the rate of corneal decompensation requiring corneal graft following the implantation of a Baerveldt or Ahmed glaucoma valve in a tertiary-care center.

 

Study design: Retrospective cohort study

 

Methods: All patients 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 from the study. Primary outcomes were rates of corneal decompensation requiring corneal graft in relation to preoperative glaucoma type, incisional surgery, and lens status.

 

Results: This study included 865 eyes of the initial 914 eyes that underwent surgery for a glaucoma drainage implant. The median age of patients who received a glaucoma implant was 68 years. In the study cohort, the distribution of glaucoma types included primary open angle glaucomas (55%), neovascular glaucomas (11%), uveitic glaucomas (10%), primary closed angle glaucomas 7%), traumatic glaucomas (4%) and juvenile glaucomas (3%). There was a statistically significant difference between the types of glaucoma and the rates of corneal decompensation requiring corneal grafts ranging from 2.1% of patients with GNV to 23% of patients with traumatic glaucoma (p = 0.008). Patients with a previous incisional surgery (e.g., trabeculectomy, bleb-forming implants) had higher rates of corneal decompensation requiring corneal graft (with incisional surgery: 14% vs. without incisional surgery: 7%; p<0.001).

 

Conclusion: Traumatic glaucomas displayed the highest rate of decompensation requiring corneal graft. Patients with a history of incisional surgery equally had higher rates of corneal decompensation at follow-up. Our findings suggest that patients with traumatic glaucoma or patients with a history of incisional surgery may need more frequent follow-ups after valve implantation.

Presenter(s)

Presenting Author: Aaron Xu

Additional Author(s):

Rayan Tolba, Université Laval

Laurence Bussières, Université Laval

Mélanie Hébert, Université Laval

Caroline Lajoie, Université Laval

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