PT  - JOURNAL ARTICLE
AU  - Kaushik, Sushmita
AU  - Kataria, Pankaj
AU  - Raj, Srishti
AU  - Pandav, Surinder Singh
AU  - Ram, Jagat
TI  - Safety and efficacy of a low-cost glaucoma drainage device for refractory childhood glaucoma
AID  - 10.1136/bjophthalmol-2017-310276
DP  - 2017 Dec 01
TA  - British Journal of Ophthalmology
PG  - 1623--1627
VI  - 101
IP  - 12
4099  - http://bjo.bmj.com/content/101/12/1623.short
4100  - http://bjo.bmj.com/content/101/12/1623.full
SO  - Br J Ophthalmol2017 Dec 01; 101
AB  - Background To evaluate the safety and efficacy of a low-cost glaucoma drainage device (GDD), Aurolab aqueous drainage implant (AADI), similar in design to the Baerveldt glaucoma implant (BGI), in refractory childhood glaucoma.Methods This prospective interventional study was conducted in a tertiary care postgraduate teaching institute. Children aged <16 years with uncontrolled intraocular pressure (IOP) refractory to medical treatment and considered at high risk of failure following trabeculectomy were recruited. Eligible children were implanted with the AADI. Those completing minimum 6-month follow-up were included. Main outcome measures were IOP reduction from preoperative values and postoperative complications.Results 34 eyes of 31 patients were analysed. Average follow-up was 18.3±6.9 months. Mean IOP reduced from 27.4±7.5 mm Hg on maximum medication to 14.6±10.74 mm Hg, 13.8±7.5 mm Hg, 12.8±5.6 mm Hg and 14.7±5.8 mm Hg at 1 week, 6 months, 1 year (32 eyes of 29 children) and 2 years (25 eyes of 22 children) postoperatively, respectively (p<0.001). The cumulative probability of success was 91.18% at 6 months and 81.7% at 18–24 months. Mean number of topical medications decreased from 3.1±0.6 to 1.8±1.3 at 6 months and 1.6±1.1 at 24 months (p<0.001). Preoperatively, 25 patients required systemic acetazolamide, decreasing to three patients at 2 years. There was no tube erosion or infection. One eye developed retinal detachment.Conclusion 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.