Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma Patients

Purpose. To assess outcomes of anterior chamber (AC), sulcus, and pars plana (PP) glaucoma drainage device (GDD) placement in glaucoma patients. Patients and Methods. Retrospective evaluation of glaucoma patients who underwent GDD insertion in the AC, sulcus, or PP at Massachusetts Eye and Ear betwe...

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Main Authors: Sandy Samuel, Enchi K. Chang, Sanchay Gupta, Marika Chachanidze, Cameron E. Neeson, John B. Miller, Ta Chen Chang, David A. Solá-Del Valle
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2022/5947992
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author Sandy Samuel
Enchi K. Chang
Sanchay Gupta
Marika Chachanidze
Cameron E. Neeson
John B. Miller
Ta Chen Chang
David A. Solá-Del Valle
author_facet Sandy Samuel
Enchi K. Chang
Sanchay Gupta
Marika Chachanidze
Cameron E. Neeson
John B. Miller
Ta Chen Chang
David A. Solá-Del Valle
author_sort Sandy Samuel
collection DOAJ
description Purpose. To assess outcomes of anterior chamber (AC), sulcus, and pars plana (PP) glaucoma drainage device (GDD) placement in glaucoma patients. Patients and Methods. Retrospective evaluation of glaucoma patients who underwent GDD insertion in the AC, sulcus, or PP at Massachusetts Eye and Ear between November 2016 and May 2021. Patients who received AC, sulcus, and pars plana tubes were selected using simple random sampling, and the first 40 patients meeting inclusion criteria were analyzed. Main outcome measures were cumulative success probabilities from Kaplan-Meier (KM) analyses, intraocular pressure (IOP), medication burden, and complication rates. Results. The PP group had a larger proportion of Ahmed GDDs and was younger on average with less severe glaucoma compared to patients with AC or sulcus tubes. The PP group had a higher proportion of mixed-mechanism glaucoma and lower proportion of primary open-angle glaucoma. With success defined as IOP reduction ≥20% and 5 < IOP ≤ 21 mm Hg, the Kaplan-Meier cumulative success probabilities for all three GDD locations were not significantly different. No significant differences were found in complication rates between all groups after 3 months. Patients with PP GDD had significantly lower medication burden than those with AC or sulcus GDDs up to 1.5 years postoperatively (1.7 ± 1.1, 3.0 ± 1.4, and 2.8 ± 1.2 for PP, AC, and sulcus, respectively; P=0.017). Conclusion. PP GDDs may be more effective in lowering medication burden than AC or sulcus tubes without compromising long-term safety.
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spelling doaj-art-43f8cec8d6a644a28a64c7f2666842102025-08-20T02:05:50ZengWileyJournal of Ophthalmology2090-00582022-01-01202210.1155/2022/5947992Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma PatientsSandy Samuel0Enchi K. Chang1Sanchay Gupta2Marika Chachanidze3Cameron E. Neeson4John B. Miller5Ta Chen Chang6David A. Solá-Del Valle7Massachusetts Eye and EarMassachusetts Eye and EarMassachusetts Eye and EarMassachusetts Eye and EarMassachusetts Eye and EarMassachusetts Eye and EarBascom Palmer Eye InstituteMassachusetts Eye and EarPurpose. To assess outcomes of anterior chamber (AC), sulcus, and pars plana (PP) glaucoma drainage device (GDD) placement in glaucoma patients. Patients and Methods. Retrospective evaluation of glaucoma patients who underwent GDD insertion in the AC, sulcus, or PP at Massachusetts Eye and Ear between November 2016 and May 2021. Patients who received AC, sulcus, and pars plana tubes were selected using simple random sampling, and the first 40 patients meeting inclusion criteria were analyzed. Main outcome measures were cumulative success probabilities from Kaplan-Meier (KM) analyses, intraocular pressure (IOP), medication burden, and complication rates. Results. The PP group had a larger proportion of Ahmed GDDs and was younger on average with less severe glaucoma compared to patients with AC or sulcus tubes. The PP group had a higher proportion of mixed-mechanism glaucoma and lower proportion of primary open-angle glaucoma. With success defined as IOP reduction ≥20% and 5 < IOP ≤ 21 mm Hg, the Kaplan-Meier cumulative success probabilities for all three GDD locations were not significantly different. No significant differences were found in complication rates between all groups after 3 months. Patients with PP GDD had significantly lower medication burden than those with AC or sulcus GDDs up to 1.5 years postoperatively (1.7 ± 1.1, 3.0 ± 1.4, and 2.8 ± 1.2 for PP, AC, and sulcus, respectively; P=0.017). Conclusion. PP GDDs may be more effective in lowering medication burden than AC or sulcus tubes without compromising long-term safety.http://dx.doi.org/10.1155/2022/5947992
spellingShingle Sandy Samuel
Enchi K. Chang
Sanchay Gupta
Marika Chachanidze
Cameron E. Neeson
John B. Miller
Ta Chen Chang
David A. Solá-Del Valle
Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma Patients
Journal of Ophthalmology
title Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma Patients
title_full Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma Patients
title_fullStr Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma Patients
title_full_unstemmed Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma Patients
title_short Outcomes of Anterior Chamber, Sulcus, and Pars Plana Glaucoma Drainage Device Placement in Glaucoma Patients
title_sort outcomes of anterior chamber sulcus and pars plana glaucoma drainage device placement in glaucoma patients
url http://dx.doi.org/10.1155/2022/5947992
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