Intermediate-term Outcomes of Glaucoma Drainage Device Implantation in Adults of Advanced Age.

Abstract

Aim and background: To compare outcomes of glaucoma tube shunt surgery in patients aged 85 years and older to younger adults.

Methods: Medical records were reviewed involving 207 consecutive tube shunt surgeries performed by one surgeon between 2013 and 2019. Baseline characteristics between group A (adults aged <85) and group B (aged ≥85) were compared. Changes from baseline to 12 months were compared between groups.

Results: One-year follow-up was completed for 80 of 125 eyes (group A) and 49 of 82 eyes (group B). Intraocular pressure (IOP) and number of medications were statistically significantly reduced at 12 months, with no significant difference between groups (group A: 33.1 ± 11.2 → 13.8 ± 4.5 mm Hg, group B: IOP 33.6 ± 10.2 → 14.0 ± 4.3 mm Hg; p = 0.7168; group A: 3.2 ± 1.2 → 1.6 ± 1.3 meds, group B: 3.2 ± 1.1 → 1.8 ± 1.4 meds; p = 0.8404). Success rate was 109/128 (85.1%) overall, with no significant difference between groups (p = 0.2625). LogMAR visual acuity (VA) significantly worsened in group B only (group A: 0.68 ± 0.59 preop → 0.67 ± 0.58 postop; group B: 0.79 ± 0.60 preop → 0.98 ± 0.73 postop; p = 0.0006). More older patients lost ≥0.25 logMAR VA (group A: 11/80 = 14% vs group B: 17/49 = 35%; p = 0.0051).

Conclusion: For advanced-age patients, tube shunt surgery provides good intraocular pressure control, with a higher, though acceptable, risk of loss of VA.

Clinical significance: Tube shunts may be undertaken in patients of advanced age at high risk of vision loss from glaucoma.

How to cite this article: Werner M, Byun S, Shin R, et al. Intermediate-term Outcomes of Glaucoma Drainage Device Implantation in Adults of Advanced Age. J Curr Glaucoma Pract 2024;18(4):162-170.