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Long-term surgical outcomes of Aurolab aqueous drainage implant in pediatric eyes with primary congenital glaucoma versus aphakic glaucoma
  1. George Varghese Puthuran1,
  2. Sujitha Ramesh1,
  3. Peethala Maheswari1,
  4. Madan Mohan Reddy1,
  5. Mohammed Sithiq Uduman S2,
  6. Subbaiah Ramasamy Krishnadas1,
  7. Steven J Gedde3
  1. 1Glaucoma Services, Aravind Eye Hospital, Madurai, India
  2. 2Biostatistics, Aravind Eye Hospital, Madurai, Tamil Nadu, India
  3. 3Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida, USA
  1. Correspondence to Dr George Varghese Puthuran, Aravind Eye Hospital, Madurai, Tamilnadu 625020, India; georgeputhuran{at}gmail.com

Abstract

Purpose To compare the outcomes of the Aurolab aqueous drainage implant (AADI) placed in eyes with refractory primary congenital glaucoma (PCG) versus aphakic glaucoma (APG).

Design Retrospective comparative interventional case series.

Methods Case files of consecutive eyes with PCG or APG that underwent AADI surgery between January 2013 and December 2016 and had a minimum 4 years follow-up were extracted from a computerised database. Failure was defined as intraocular pressure (IOP)>21 mm Hg or reduced<20% below baseline on two consecutive follow-up visits after 3 months, IOP≤5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for glaucoma or a complication, or loss of light perception.

Results Eighty-nine eyes underwent AADI placement, including 42 eyes (47%) with PCG and 47 eyes (53%) with APG. Both groups were comparable at baseline. At 1 year, the APG group had lower mean IOP (13.6±8.1 mm Hg vs 17.6±7.5 mm Hg, p=0.02) with use of fewer IOP-lowering medications (0.8±1.0 vs 1.5±1.0, p=0.01) than the PCG group. The cumulative failure rate at 4 years was 57% (95% CI 43% to 72%) in PCG versus 40% (95% CI 28% to 56%) in the APG eyes (p=0.11). Eyes with PCG had greater tube-related complications (48% vs 38%, p=0.07) and number of reoperations (40% vs 32%, p=0.02) compared with eyes with APG.

Conclusions Eyes with APG had relatively better outcomes after AADI placement compared with PCG during 4 years of follow-up. Reoperations accounted for more than 70% of the failures.

  • Glaucoma
  • Intraocular pressure
  • Treatment Surgery

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors GVP: concept and design of work, critical revision of content, guarantor. SR, PM and MMR: data acquisition, analysis, preparation of manuscript. MSUS: data analysis, preparation of manuscript. SRK: critical revision of content. SJG: drafting the work or revising it critically for important intellectual content and 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.

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