June 5, 2020 Conference


Short-term Surgical Outcomes of Glaucoma Drainage Device Implant after Failed Trabectome Surgery

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Marez Megalla, Yale Ophthalmology (Presenter)
Yapei Zhang, Yale Eye Center
Ji Liu, Yale Eye Center
Methods: Retrospective chart review of GDD implantation after failed trabectome during 2013-2019. Outcome measures were intraocular pressure (IOP), number of IOP-lowering medications and surgical complications at 12 months after GDD. Unpaired t-test was used for statistical analysis. Results: Fourteen eyes were included. The interval time between trabectome and GDD ranged from 7 days to 32 months (14.875±9.07). The average IOP was 27.14±8.37mmHg with 2.9±0.7 medications prior to trabectome, and 27.8±7.62 with 3.3±0.9 medications prior to GDD (pre-GDD). After GDD surgery, average IOP was reduced to 14.7±4.8mmHg (p=<0.00001) with 2±1.7 medications (p=0.008 vs pre-GDD) at the 12-month visit. No major surgical complications were documented for either trabectome or GDD surgery. Discussion: Trabectome surgery has been found effective in treating open angle glaucoma,1 Studies assessing the effectiveness of trabectome during GDD and after failed GDD have also shown significant reductions in IOP.2,3 However, some eyes may fail to respond to the primary trabectome surgery. It is unclear if these eyes would respond to sequential GDD. Our data indicated placement of a GDD after failed trabectome still resulted in significantly reduced IOP and medication usage without major surgical complications. Conclusion: Trabectome failure did not affect surgical outcomes of sequential GDD surgery, which can serve as a rescue for further IOP control.
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