Resultados a medio plazo de los dispositivos de drenaje para glacuoma
- C. Merino-de-Palacios
- E. Gutiérrez-Díaz
- A. Chacón-Garcés
- M. Montero-Rodríguez
- E. Mencía-Gutiérrez
ISSN: 0365-6691
Year of publication: 2008
Volume: 83
Issue: 1
Pages: 15-22
Type: Article
More publications in: Archivos de la Sociedad Española de Oftalmologia
Abstract
Objective: To study the intermediate-term results of glaucoma drainage devices (DDG) with respect to control of intraocular pressure (IOP), control of glaucoma, and maintenance of pre-operative visual acuity. Methods: This was a retrospective cohort study of 86 eyes in 77 patients in whom a DDG was implanted, using descriptive statistics and survival analysis. Results: Success was achieved in 53 eyes (61.6%), complete (without treatment) in 34 eyes (39.5%) and qualified (needing treatment) in 19 eyes (22.1%). In the 33 eyes where the DDG treatment was unsuccessful, poor IOP control occurred in 13 eyes - (15.1%), and complications occurred in 20 eyes (23.2%) resulting in a severe reduction or loss of visual acuity (plate exposure, suprachoroidal hemorrhage, retinal detachment). IOP control was obtained in 66 eyes (76.7%), 47 of them without treatment (54.6%), although on 13 occasions the overall treatment failed due to complications occurring. Despite IOP control, glaucoma progression occurred in 7 eyes (8.1%). Preoperative vision was maintained in 46 eyes (53.5%), but decreased by 3 or more lines in 20 eyes (46.5%); bullous kerathopathy was the most frequent cause of the worsening. Loss of light perception occurred in 21 eyes (24.4%) and 4 eyes (4.6%) were eviscerated. Conclusions: DDG are an effective surgical option for control of IOP when conventional surgery has a poor prognosis, but they are associated with an increased risk of serious complications and loss of visual acuity in a significant proportion of cases.
Bibliographic References
- Gutiérrez Díaz, E, Montero Rodríguez, M. (2002). Dispositivos de drenaje para glaucoma. Ediciones Ergon, S.A.. Madrid.
- García Sánchez, J, Arias Puente, A, García Feijoó, J. (1998). Nueva estrategia terapéutica antiglaucomatosa. Jarpyo Editores SA.. Madrid.
- Molteno, AC, Bevin, TH, Herbison, P, Houliston, MJ. (2001). Otago glaucoma surgery outcome study: long-term follow-up of cases of primary glaucoma with additional risk factors drained by Molteno implants. Ophthalmology. 108. 2193-2200
- Molteno, AC, Whittaker, KW, Bevin, TH, Herbison, P. (2004). Otago Glaucoma Surgery Outcome Study: long term results of cataract extraction combined with Molteno implant insertion or trabeculectomy in primary glaucoma. Br J Ophthamol. 88. 32-35
- Fuller, JR, Bevin, TH, Molteno, AC. (2001). Long-term of traumatic glaucoma treated with Molteno implants. Ophthalmology. 108. 1796-1800
- Molteno, AC, Sayawat, N, Herbison, P. (2001). Otago glaucoma surgery outcome study: Long-term results of uveitis with secondary glaucoma drained by Molteno implants. Ophthalmology. 108. 605-613
- Ah-Chan, JJ, Molteno, AC, Bevin, TH, Herbison, P. (2005). Otago Glaucoma Surgery Outcome Study: follow-up of young patients who underwent Molteno implant surgery. Ophthalmology. 112. 2137-2142
- Every, SG, Molteno, AC, Bevin, TH, Herbison, P. (2006). Long-term results of Molteno implant insertion in cases of neovascular glaucoma. Arch Ophthalmol. 124. 355-360
- Topouzis, F, Coleman, AL, Choplin, N, Bethlem, MM, Hill, R, Yu, F. (1999). Follow-up of the original cohort with the Ahmed glaucoma valve implant. Am J Ophthalmol. 128. 198-204
- Broadway, DC, Iester, M, Schulzer, M, Douglas, GR. (2001). Survival analysis for success of Molteno tube implants. Br J Ophthalmol. 85. 689-695
- Mills, RP, Reynolds, A, Emond, MJ, Barlow, WE, Leen, MM. (1996). Long-term survival of Molteno glaucoma drainage devices. Ophthalmology. 103. 299-305
- Eid, TE, Katz, LJ, Spaeth, GL, Augsburger, JJ. (1997). Long-term effects of tube-shunt procedures on management of refractory childhood glaucoma. Ophthamology. 104. 1011-1016
- Irak, I, Moster, MR, Fontanarosa, J. (2004). Intermediate-term results of Baerveldt tube shunt surgery with mitomycin C use. Ophthalmic Surg Lasers Imaging. 35. 189-196