Safety and efficacy of a low-cost glaucoma drainage device for refractory childhood glaucoma

Kaushik, Sushmita; Kataria, Pankaj; Raj, Srishti; Pandav, Surinder Singh; Ram, Jagat

doi:10.1136/bjophthalmol-2017-310276

Cited by 50 publications

(35 citation statements)

References 18 publications

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“…A prospective study in 34 eyes of paediatric refractory glaucomas with an average follow-up of 18.3±6.9 months reported the cumulative probability of success of 91.18% at 6 months and 81.7% at 18–24 months with a significantly lower IOP and AGM requirement in the postoperative period 4. Our own cohort of 54 AADI implantations2 had very similar success rate (overall success was 92.6%) at 12.1±6.3 months.…”

Section: Discussionsupporting

confidence: 51%

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Pathak-Ray

Rao

2018

Br J Ophthalmol

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Section: Discussionsupporting

confidence: 51%

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Pathak-Ray

Rao

2018

Br J Ophthalmol

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“…is is similar to that reported in previous studies using the BGI in children. ere were no serious complications or endophthalmitis during the follow-up period [5]. In our study, the AADI yielded similar provisional success rates in many cases and a mean IOP reduction similar to those reported in previous studies that evaluated the use of the AADI.…”

Section: Discussionsupporting

confidence: 88%

“…However, a low-cost prototype of the Baerveldt implant that has recently become available called the Aurolab aqueous drainage implant (AADI, Aurolabs, Madurai, India). Its low cost, at approximately 1/15, the price of the BGI is a very strong advantage, and the efficacy and safety of AADI implant was comparable with BGI in recent studies [5,6], but little data are available regarding the safety and efficacy of the AADI outside India, the manufacturing country of the device.…”

Section: Introductionmentioning

confidence: 99%

Outcome of a Low-Cost Glaucoma Implant versus the Baerveldt Glaucoma Implant for Paediatric Glaucoma in a Tertiary Hospital in Egypt

Rateb

Abdelmotaal

Salim

et al. 2019

Journal of Ophthalmology

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Purpose. To compare safety and efficacy between a low-cost glaucoma drainage device (GDD), the Aurolab aqueous drainage implant (AADI), and the Baerveldt glaucoma implant (BGI) in refractory childhood glaucoma in Egypt. Methods. This is a retrospective study of patients who received either an AADI or BGI at a tertiary care postgraduate teaching institute. Children aged <16 years with uncontrolled intraocular pressure (IOP) with or without prior failed trabeculectomy who completed a minimum 6-month follow-up were included. The outcome measures were IOP reduction from preoperative values and postoperative complications. Results. Charts of 57 children (younger than 16 years old) diagnosed with refractory childhood glaucoma were included. Of these, 27 eyes received AADI implants (group A), while 30 received BGI implants (group B). The mean preoperative baseline IOP was 34 ± 5 mmHg in group A versus 29 ± 2 mmHg in group B (p=0.78) in patients on maximum allowed glaucoma medications. In group A versus group B, the mean IOP decreased to 13.25 ± 8.74 mmHg (p=0.6), 12.8 ± 5.4 mmHg (p=0.7), and 12.6 ± 5.6 mmHg (p=0.9) after 1 week, 3 months, and 6 months, respectively. However, in group A, an anterior chamber reaction appeared around the tube in 14 cases starting from the first month and resolved with treatment in only 4 cases. In the other 10 cases, the reaction became more severe and required surgical intervention. This complication was not observed in any eye in group B. Conclusion. AADI, a low-cost glaucoma implant, is effective in lowering IOP in patients with recalcitrant paediatric glaucoma. However, an intense inflammatory reaction with serious consequences developed in some of our patients; we believe these events are related to the valve material. We therefore strongly recommend against its use in children.

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“…[ 3 4 ] The 32-mm long end plate extends beyond 2 clock hours of circumference on the equatorial sclera. Though the implant is available for use in India, there are only a couple of published data about the safety or efficacy of this implant;[ 5 6 ] however, none of the studies were compared same with AGV implant. The purpose of this study was to assess the safety and efficacy of AADI and compare it with AGV.…”

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confidence: 99%

A prospective randomized controlled study of Aurolab aqueous drainage implant versus Ahmed glaucoma valve in refractory glaucoma: A pilot study

Rathi

Seth

Kaur

et al. 2018

Indian J Ophthalmol

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Purpose:To study the efficacy of the Aurolab aqueous drainage implant (AADI) compared to Ahmed glaucoma valve (AGV) in patients with refractory glaucoma.Methods:This was a prospective, randomized controlled trial. Thirty-eight adult patients (>18 years) scheduled for a glaucoma drainage device (GDD) were randomized into two groups to receive either AGV or AADI. Primary outcome measures: intraocular pressure (IOP) control and requirement of antiglaucoma medications; secondary outcome measures: final best correct visual acuity (log MAR), visual field (Visual field index [VFI], mean deviation [MD] and pattern standard deviation [PSD]), postoperative complications and additional interventions. Complete success was defined as IOP ≥5–≤18 mmHg without antiglaucoma medications/laser/additional glaucoma surgery or any vision threatening complications.Results:There were 19 age and sex-matched patients in each group. Both groups had comparable IOP before surgery (P = 0.61). The AGV group had significantly lower IOP compared to AADI group (7.05 ± 4.22 mmHg vs 17.90 ± 10.32 mmHg, P = <0.001) at 1 week. The mean postoperative IOP at 6 months was not significantly different in the two groups (13.3 ± 4.2 and 11.4 ± 6.8 mmHg respectively; P = 0.48). At 6 months, complete success rate according to antiglaucoma medication criteria was 78.94% in AADI and 47.36% in AGV groups. AGV group required 1.83 times more number of topical medications than AADI group. There was no significant difference in early (P = 0.75) and late (P = 0.71) postoperative complications in the AADI and AGV group. The complete success rate was higher in AADI group (68.42%) than AGV group (26.31%) (P = 0.034).Conclusion:In this study, AADI appears to have comparable efficacy versus AGV implant with higher complete success rate at 6 months follow-up.

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Safety and efficacy of a low-cost glaucoma drainage device for refractory childhood glaucoma

Abstract: The AADI appears to be a viable low-cost GDD with effectiveness and safety profile comparable with published reports of the BGI and Ahmed glaucoma valve implant in children.

Cited by 50 publications

References 18 publications

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Surgical outcomes of a new affordable non-valved glaucoma drainage device and Ahmed glaucoma valve: comparison in the first year

Outcome of a Low-Cost Glaucoma Implant versus the Baerveldt Glaucoma Implant for Paediatric Glaucoma in a Tertiary Hospital in Egypt

A prospective randomized controlled study of Aurolab aqueous drainage implant versus Ahmed glaucoma valve in refractory glaucoma: A pilot study

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