Failed glaucoma drainage implant: long-term outcomes of a second glaucoma drainage device versus cyclophotocoagulation

Abstract

After failure of an initial drainage implant to control IOP, a sequential tube had a high initial rate of success but a relatively high likelihood of long-term failure, generally after 6 years. Eyes that received CPC tended to fail earlier, often within the first year, but had relatively few late failures.

Intermediate‐term and long‐term outcome of piggyback drainage: connecting glaucoma drainage device to a device in‐situ for improved intraocular pressure control

“…Our results suggest that piggyback GDD placement has equivalent success rates in long‐term control of IOP compared with separate additional GDD insertion . Schaefer et al .…”

“…Successful control of IOP following the addition of another implant approximates 50% with a 25% IOP reduction at 6 years . This is similar to a 40% failure of second implant at 6 years requiring further procedures . A major concern is that additional anterior chamber tubes increase the risk of corneal decompensation with rates ranging between 16% and 45% quoted in the literature …”

“…and 11.7% in a study by Shah et al . The most successful option has been the insertion of an additional GDD or cyclodestruction …”

“…Schaefer et al . explored the long‐term efficacy of a second GDD after failure of a primary drainage implant finding a success rate of 40% with a mean follow‐up of 132 months . Burgoyne et al .…”

“…reported success of a second GDD into the anterior chamber of 50%, with an average follow‐up of 35 months . Other studies in the literature report success rates between 40% and 60%, depending on the duration of follow‐up and the success criteria . Three studies evaluating efficacy of cyclodestructive procedures following a failed primary GDD have been published in the literature.…”