Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia

Purpose: To evaluate the safety and efficacy outcomes of aqueous shunt implant with/without intraoperative mitomycin-C (MMC) in glaucoma secondary to congenital Aniridia and risk factors associated with its success. Design: Retrospective study Subjects: Patients with congenital Aniridia who underwen...

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Main Authors: Jeremy C.K. Tan, Abdus Samad Ansari, Nicholas G. Strouthidis, John Brookes, Peng T Khaw, Keith Barton, Renata Puertas
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:AJO International
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950253525000176
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author Jeremy C.K. Tan
Abdus Samad Ansari
Nicholas G. Strouthidis
John Brookes
Peng T Khaw
Keith Barton
Renata Puertas
author_facet Jeremy C.K. Tan
Abdus Samad Ansari
Nicholas G. Strouthidis
John Brookes
Peng T Khaw
Keith Barton
Renata Puertas
author_sort Jeremy C.K. Tan
collection DOAJ
description Purpose: To evaluate the safety and efficacy outcomes of aqueous shunt implant with/without intraoperative mitomycin-C (MMC) in glaucoma secondary to congenital Aniridia and risk factors associated with its success. Design: Retrospective study Subjects: Patients with congenital Aniridia who underwent aqueous shunt implantation with/without intraoperative MMC for glaucoma at Moorfields Eye Hospital London between 2012 and 2021 with at least 3 years follow-up. Methods: The primary outcome was success at 3 years defined by intraocular pressure (IOP) reduction ≥ 20 % from baseline and final IOP between 6 and 21 mmHg with/without (overall) or without (complete) medications, without further glaucoma surgery or loss of light perception. Results: Altogether 28 eyes of 23 patients were included, with a mean age of 33.1 (SD 18.3) years. The baseline IOP, medications and visual acuity were 23.4 (SD 8.3), 3.0 (SD 0.9) and 1.6 (SD 0.7) logMAR respectively. Intraoperative MMC was used in 15 (53.6 %) cases. At 3 years the proportion of complete and overall success was 44.0 % and 92.0 % respectively, with a significant reduction in IOP (-11.0, CI -14.0 to -8.0, p < 0.001) and medication use (-1.7, CI -2.3 to -1.2, p < 0.001), and no significant change in VA. There was no significant association between baseline IOP, number of medications and VA, lens status, MMC use, removal of stent suture and surgical success. Conclusions: Aqueous shunt implant is effective at reducing IOP and medication use at 3 years in glaucoma secondary to congenital Aniridia, with no significant change in visual acuity observed post-operatively.
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spelling doaj-art-3fe9d21adbc741ed89c812abe844fb3c2025-08-20T03:26:35ZengElsevierAJO International2950-25352025-07-012210011410.1016/j.ajoint.2025.100114Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridiaJeremy C.K. Tan0Abdus Samad Ansari1Nicholas G. Strouthidis2John Brookes3Peng T Khaw4Keith Barton5Renata Puertas6Faculty of Medicine and Health, University of New South Wales, Kensington, NSW, Australia; Department of Ophthalmology, Prince of Wales Hospital, Sydney, NSW, Australia; Glaucoma service, Moorfields Eye Hospital NHS Foundation Trust, London, UK; Corresponding author at: Prince of Wales Hospital Eye Clinic, Level 4, The Prince of Wales Hospital, High Street Building, Randwick NSW 2031, Australia.Glaucoma service, Moorfields Eye Hospital NHS Foundation Trust, London, UKGlaucoma service, Moorfields Eye Hospital NHS Foundation Trust, London, UK; Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, NSW, AustraliaGlaucoma service, Moorfields Eye Hospital NHS Foundation Trust, London, UKGlaucoma service, Moorfields Eye Hospital NHS Foundation Trust, London, UKGlaucoma service, Moorfields Eye Hospital NHS Foundation Trust, London, UKGlaucoma service, Moorfields Eye Hospital NHS Foundation Trust, London, UKPurpose: To evaluate the safety and efficacy outcomes of aqueous shunt implant with/without intraoperative mitomycin-C (MMC) in glaucoma secondary to congenital Aniridia and risk factors associated with its success. Design: Retrospective study Subjects: Patients with congenital Aniridia who underwent aqueous shunt implantation with/without intraoperative MMC for glaucoma at Moorfields Eye Hospital London between 2012 and 2021 with at least 3 years follow-up. Methods: The primary outcome was success at 3 years defined by intraocular pressure (IOP) reduction ≥ 20 % from baseline and final IOP between 6 and 21 mmHg with/without (overall) or without (complete) medications, without further glaucoma surgery or loss of light perception. Results: Altogether 28 eyes of 23 patients were included, with a mean age of 33.1 (SD 18.3) years. The baseline IOP, medications and visual acuity were 23.4 (SD 8.3), 3.0 (SD 0.9) and 1.6 (SD 0.7) logMAR respectively. Intraoperative MMC was used in 15 (53.6 %) cases. At 3 years the proportion of complete and overall success was 44.0 % and 92.0 % respectively, with a significant reduction in IOP (-11.0, CI -14.0 to -8.0, p < 0.001) and medication use (-1.7, CI -2.3 to -1.2, p < 0.001), and no significant change in VA. There was no significant association between baseline IOP, number of medications and VA, lens status, MMC use, removal of stent suture and surgical success. Conclusions: Aqueous shunt implant is effective at reducing IOP and medication use at 3 years in glaucoma secondary to congenital Aniridia, with no significant change in visual acuity observed post-operatively.http://www.sciencedirect.com/science/article/pii/S2950253525000176AniridiaGlaucomaAqueous shunt procedureBaerveldt glaucoma implantPaul glaucoma implant tube implant
spellingShingle Jeremy C.K. Tan
Abdus Samad Ansari
Nicholas G. Strouthidis
John Brookes
Peng T Khaw
Keith Barton
Renata Puertas
Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia
AJO International
Aniridia
Glaucoma
Aqueous shunt procedure
Baerveldt glaucoma implant
Paul glaucoma implant tube implant
title Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia
title_full Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia
title_fullStr Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia
title_full_unstemmed Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia
title_short Outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia
title_sort outcomes of aqueous shunt surgery in glaucoma secondary to congenital aniridia
topic Aniridia
Glaucoma
Aqueous shunt procedure
Baerveldt glaucoma implant
Paul glaucoma implant tube implant
url http://www.sciencedirect.com/science/article/pii/S2950253525000176
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