Efficacy of glaucoma drainage devices in uveitic glaucoma and a meta-analysis of the literature

Ramdas, Wishal D.; Pals, Jan; Rothová, Aniki; Wolfs, Roger C. W.

doi:10.1007/s00417-018-4156-9

Cited by 40 publications

(41 citation statements)

References 39 publications

(22 reference statements)

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“…These results are in agreement with those of other studies with QS rates between 75% and 89.5% and suggest that GDD surgery in patients with uveitis has a similar effect on IOP as in patients without uveitis. 11,13,18,19 Nevertheless, the uveitic group in our study showed less IOP control than other aetiologies, since only 57.1% of the QS eyes achieved CS. Various studies have investigated the efficacy of GDD in developmental glaucoma, but the few that used double-plate implants reported differing results, with success rates ranging from 100% to 59%.…”

Section: Discussioncontrasting

confidence: 68%

Risk Factors for Failure in Double-Plate Tube Surgery for Refractory Glaucoma: 25 Years Surgical Experience

Duch¹,

Arciniegas-Perasso²,

Piludu³

et al. 2021

OPTH

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Purpose: To investigate risk factors associated with success and failure in double-plate tube surgery. Methods: This retrospective case-series observational study included 243 consecutive eyes that underwent anterior-segment double-plate tube surgery from 1990 to 2015. Evaluation of the efficacy of the device was based on the final intraocular pressure (IOP) and the need for anti-glaucoma medication. We also assessed success and failure according to risk factors for trabeculectomy and an early hypertensive phase (HP). Results: Preoperative IOP was 37.3±13.1 mmHg (mean±SD) with 3.0±0.7 medications. After a median follow-up of 44.3 months, the mean IOP was 14.6±6.3 mmHg with 0.4±1.0 medications. The final IOPs ranged from 6 to 21 mmHg in 87.24% of eyes; however, 25.47% required medication. No risk factors studied were associated with surgical failure. Preoperative IOP, glaucoma type, previous surgery, previous anti-glaucoma drugs, implant type, and HP were associated with partial success (p<0.05). HP and preoperative use of brimonidine reduced the probability of complete success by 66.9% and 68.2%, respectively (p<0.05). HP was more likely when chronic preoperative prostaglandin analogues were administered (odds ratio [OR] 4.286; 95% confidence intervals [CI] 1.593-11.529; P=0.0039) and when the tube was located in the posterior chamber (OR 3.561; 95% CI 1.286-9.861; P=0.0145). Conclusion: Tube surgery is effective and seems to be independent of the major risk factors for glaucoma surgery. However, previous surgery and some chronic preoperative drugs are related to the need for glaucoma medication to achieve the target pressure.

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Section: Discussioncontrasting

confidence: 68%

Risk Factors for Failure in Double-Plate Tube Surgery for Refractory Glaucoma: 25 Years Surgical Experience

Duch¹,

Arciniegas-Perasso²,

Piludu³

et al. 2021

OPTH

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“…The potential for any of these drugs to cause adverse events must be considered, and alpha‐2 adrenergic agonists in particular should not be prescribed to infants or young children as they may develop serious central nervous system complications. Valve implants have a longer survival time in patients with uveitis, 27 and the effect on intraocular pressure control is comparable between uveitic and non‐uveitic glaucoma 28 . For most children with JIA‐type uveitis and secondary glaucoma that requires surgical intervention, the Working Group members preferred this procedure.…”

Section: Resultsmentioning

confidence: 99%

Recommendations for the management of childhood juvenile idiopathic arthritis‐type chronic anterior uveitis

Smith

Matthews

Conrad

et al. 2021

Clinical Exper Ophthalmology

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Importance Australian‐ and New Zealand‐based, uveitis‐specialized ophthalmologists have produced recommendations for the management of juvenile idiopathic arthritis (JIA)‐type chronic anterior uveitis. Background Historically, the visual prognosis of JIA‐type chronic anterior uveitis has been poor. New medical advances are likely to improve outcomes, but recently published guidelines are tailored for ophthalmic care in Europe and the United States. Design This work involved a consensus survey and a panel meeting. Participants The Australian and New Zealand JIA‐Uveitis Working Group (29 ophthalmologists) participated in the work. Methods The Delphi technique was used to achieve consensus. Main Outcome Measures This work yielded consensus statements. Results The Working Group achieved consensus around 18 statements related to clinical evaluation, use of topical and regional corticosteroids, use of systemic corticosteroid and non‐corticosteroid immunomodulatory drugs, and management of secondary cataract and glaucoma in childhood JIA‐type uveitis. Conclusions and Relevance Recommendations of the Australian and New Zealand JIA‐Uveitis Working Group provide current and regionally applicable advice for managing chronic anterior uveitis in children with JIA.

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“…Fixed combinations of eye drops were calculated as two separate drugs. Hypotony was defined as an IOP ≤ 4 mmHg at two or more consecutive visits (excluding one-day postoperative) during the first year of follow-up [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature

Poelman

Pals

Rostamzad

et al. 2021

JCM

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Background: To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data. Methods: Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 onwards. Sub-analyses were performed for eyes that underwent XEN-implant as standalone procedure and as cataract-combined procedure. To compare our results, a systematic review was performed using the Embase, PubMed, Web of Science, and Cochrane database. Meta-analyses were performed by combining data (intraocular pressure (IOP), IOP-lowering medication, and complications) from the retrieved studies. Results: A total of 221 eyes underwent XEN-implant surgery (124 standalone and 97 cataract-combined). The mean ± standard deviation IOP declined from 18.8 ± 6.5 to 13.5 ± 4.3 mmHg at the last follow-up (p < 0.001; 28.9%). Postoperative, no significant differences in IOP or IOP-lowering medication were found between patients with and without combined procedure. Secondary surgeries were performed in 20.8% of eyes, most of them (63.0%) within six months. A meta-analysis of 19 studies retrieved from the systematic review showed a two-years postoperative pooled mean (weighted mean difference) of 14.5 (7.3) mmHg and 1.0 (1.6) for IOP and IOP-lowering medications, respectively (compared to 13.5 (5.3) mmHg and 3.2 (2.4) in the current study). Conclusion: XEN-implant surgery was effective and safe in lowering IOP and the number of IOP-lowering medications. There were no differences between standalone and combined procedures.

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Efficacy of glaucoma drainage devices in uveitic glaucoma and a meta-analysis of the literature

Cited by 40 publications

References 39 publications

Risk Factors for Failure in Double-Plate Tube Surgery for Refractory Glaucoma: 25 Years Surgical Experience

Risk Factors for Failure in Double-Plate Tube Surgery for Refractory Glaucoma: 25 Years Surgical Experience

Recommendations for the management of childhood juvenile idiopathic arthritis‐type chronic anterior uveitis

Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature

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