Surgical Options for Glaucoma Patients With Failed Glaucoma Drainage Devices: A Systematic Review.
Pedro Marques-Couto, Sofia Machado, Gonçalo P Azevedo et al.
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In 30 seconds
This systematic review evaluated surgical options for patients with failed glaucoma drainage devices (GDDs), analyzing 44 studies involving 1560 eyes. The findings indicate that second GDD implantation (SGDD) and cyclophotocoagulation (CPC) significantly reduce intraocular pressure (IOP), with SGDD lowering IOP by >30%. However, SGDD is associated with higher complication rates compared to CPC.
Key findings
- SGDD lowered IOP by >30%, with success rates ranging from ∼30% at 3 years to >90% at 1 year.
- CPC achieved IOP reductions of 25%-45% with fewer device-related complications.
- A randomized trial showed similar efficacy between CPC and SGDD, with fewer reoperations in the CPC group.
- Pediatric outcomes were less favorable compared to adult patients.
Why it matters
Understanding the effectiveness and risks of various surgical options after GDD failure is crucial for optimizing patient outcomes in glaucoma management. This review highlights the need for careful consideration of complications associated with each surgical approach.
What to keep in mind
Evidence is limited by retrospective designs and variable definitions of success across studies.