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Intermediate-term outcomes of the Aurolab aqueous drainage implant in neovascular glaucoma
  1. Subathra Gnanavelu1,
  2. George Varghese Puthuran1,
  3. Kousalya Pavani Chiranjeevi1,
  4. Hiruni Kaushalya Wijesinghe1,
  5. Vishnuvardhan Reddy1,
  6. Iswarya Mani1,
  7. Subbaiah Ramasamy Krishnadas1,
  8. Steven Jon Gedde2
  1. 1Glaucoma Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
  2. 2University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, USA
  1. Correspondence to Dr George Varghese Puthuran, Aravind Eye Hospital, Madurai, Tamil Nadu 625 020, India; georgeputhuran{at}gmail.com

Abstract

Purpose To assess the outcomes of the non-valved Aurolab aqueous drainage implant (AADI) in neovascular glaucoma (NVG).

Methods Data of consecutive patients with NVG who underwent AADI and had a minimum follow-up of 2 years were included. The primary outcome measure was the cumulative rate of surgical failure defined as intraocular pressure (IOP) >21 mm Hg or reduced <20% below baseline, IOP ≤5 mm Hg, reoperation for glaucoma or a complication, or loss of light perception vision.

Results We included 85 eyes of 85 patients with NVG, with a mean age of 61.2±9.3 years. The most common aetiologies were proliferative diabetic retinopathy (n=43) and central retinal vein occlusion (n=24). The mean IOP decreased from 36.8±12.5 mm Hg at baseline to 15.8±7.5 mm Hg at 2-year follow-up (p<0.001) and the number of IOP-lowering medications reduced from 3.4±0.8 to 1.5±1.1 (p<0.001). The cumulative rate of failure increased from 3.1% (95% CI 1.1% to 11.8%) at 1 year to 33.8% (95% CI 20.4% to 52.5%) at 2 years. Multivariable analysis showed that eyes with open angles had a lower risk of failure (HR 0.17, 95% CI 0.10 to 1.03, p=0.09). The logarithm of minimum angle of resolution visual acuity declined from 0.98±0.7 to 1.8±1.0 at 2 years (p<0.001).

Conclusion Approximately one-third of NVG eyes that received the AADI failed after 2 years of follow-up similar to other series. Early AADI implantation at the open angle stage of NVG may yield better results.

  • intraocular pressure
  • glaucoma
  • treatment surgery

Data availability statement

Data are available on reasonable request. Not applicable.

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Data availability statement

Data are available on reasonable request. Not applicable.

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Footnotes

  • Contributors All authors made substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work. GVP: concept and design of the work, critical revision of the content, final approval of the version to be published, accountable for all aspects of work in ensuring questions related to the accuracy or integrity of any part of work are appropriately investigated and resolved. SG, HKW, SRK and SJG: concept and design of the work, critical revision of the content, final approval of the version to be published. KPC, VR and IM: data acquisition, analysis, preparation of the manuscript.

  • 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.

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

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