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Intermediate-term outcomes of Aurolab aqueous drainage implant in refractory paediatric glaucoma
  1. George Varghese Puthuran1,
  2. Paul Frederic Palmberg2,
  3. Hiruni Kaushalya Wijesinghe1,
  4. Srilekha Pallamparthy1,
  5. SR Krishnadas1,
  6. Alan L Robin3
  1. 1 Glaucoma, Aravind Eye Hospital, Madurai, India
  2. 2 Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA
  3. 3 Glaucoma, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr George Varghese Puthuran, Glaucoma, Aravind Eye Hospital, Madurai, Tamil nadu, India; georgeputhuran{at}gmail.com

Abstract

Aim To report the intermediate-term outcomes of Aurolab aqueous drainage implant (AADI) surgery in paediatric eyes with refractory glaucoma.

Methods Case records of patients below 18 years, who underwent AADI surgery between 2012 and 2015 with >2 years follow-up, were analysed. The intraocular pressure (IOP), visual acuity, number of antiglaucoma medications, complications and resurgery if any were recorded at baseline, day 1and then at months 1, 3, 6, 9, 12, 18, 24 and at the last visit. Failure was defined as IOP >18 mm Hg or not reduced by at least 30% below baseline, IOP ≤5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for a complication or loss of light perception vision.

Results 101 eyes of 101 patients were included with a mean age of 10.4±4.7 years at the time of surgery and a mean follow-up of 40.9±15.1 months. Glaucoma following cataract surgery was the most common type of glaucoma (n=31, 30%), followed by primary congenital glaucoma (n=29, 29%). The cumulative probability of failure was 15.8% (95% CI 10.1% to 24.5%) at 1 year, 22.7% (95% CI 15.7% to 32.2%) at 2 years, 42.5% (95% CI 32.6% to 53.9%) at 3 years and 62.1% (95% CI 49.5% to 74.8%) at the 4 years time point.

Conclusion The AADI showed excellent success until 2 years after surgery in paediatric eyes after which failure rates increased. Further prospective studies with longer follow-up are required to evaluate the long-term success of the AADI for paediatric glaucomas.

  • Glaucoma
  • Intraocular pressure
  • Treatment Surgery
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Footnotes

  • Contributors GVP: concept and design of work, critical revision of content, final approval of version to be published, accountable for all aspects of work in ensuring questions related to accuracy or integrity of any part of work are appropriately investigated and resolved. PFP: drafting the work or revising it critically for important intellectual content and final approval of version to be published. HKW and SP: data acquisition, analysis, preparation of manuscript. SK and ALR: critical revision of content, final approval of version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This retrospective study was approved by the institutional ethics committee of the Aravind Eye Hospital, Madurai (Institution Research Board number-RET201200196).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.

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