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Research article
David A. Solá-Del Valle
Massachusetts Eye and Ear Glaucoma Service 243 Charles Street Boston, MA 02114
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5636-6720
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The purpose of this study is to report the safety and efficacy of pars plana (PP) glaucoma drainage devices (GDDs) with pars plana vitrectomy (PPV) using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma.
Methods: Retrospective case series of 28 eyes of 28 patients who underwent combined PP GDD and PPV between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity (BCVA), and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests.
Results: Mean IOP decreased from 22.8 mmHg to 11.4 mmHg at 1.5 years (p = 0.009), and mean medication burden decreased from 4.3 to 1.7 at 1.5 years (p = 0.009). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 ≤ IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 77.7% at 1 year and 45.8% at 1.5 years. At their last visit, four eyes (14.3%) achieved complete success with IOP reduction as above without medications, and 13 eyes (46.2%) achieved qualified success with medications. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of >2 lines. Two eyes required subsequent PPV for tube obstruction, and one eye had transient hypotony.
Conclusions: The results of pars plana GDD and vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting GDDs into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.
Keywords
Glaucoma, pars plana, pars plana glaucoma drainage device, pars plana vitrectomy, Ahmed drainage implant, Baerveldt drainage implant, safety, efficacy
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CURRENT STATUS: Published
View the published article at BMC Ophthalmology.
Version 1
Posted 20 Oct, 2020
No community comments so far
Editorial decision: Minor revision
On 04 Dec, 2020
Review #3 received
Received 03 Dec, 2020
Review #4 received
Received 02 Dec, 2020
Reviewer #4 agreed
On 19 Nov, 2020
Review #1 received
Received 17 Nov, 2020
Review #2 received
Received 17 Nov, 2020
Reviewer #3 agreed
On 16 Nov, 2020
Reviewer #2 agreed
On 14 Nov, 2020
Reviewer #1 agreed
On 14 Nov, 2020
Reviewers invited
Invitations sent on 13 Nov, 2020
Editor assigned
On 01 Nov, 2020
Submission checks complete
On 13 Oct, 2020
Editor invited
On 12 Oct, 2020
First submitted
On 27 Sep, 2020
Metrics
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PDF Downloads: ...
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Subject Areas
Ophthalmology
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A new preprint design is coming!
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See the published version of this preprint at BMC Ophthalmology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
David A. Solá-Del Valle
Massachusetts Eye and Ear Glaucoma Service 243 Charles Street Boston, MA 02114
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5636-6720
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Ophthalmology.
Version 1
Posted 20 Oct, 2020
No community comments so far
Editorial decision: Minor revision
On 04 Dec, 2020
Review #3 received
Received 03 Dec, 2020
Review #4 received
Received 02 Dec, 2020
Reviewer #4 agreed
On 19 Nov, 2020
Review #1 received
Received 17 Nov, 2020
Review #2 received
Received 17 Nov, 2020
Reviewer #3 agreed
On 16 Nov, 2020
Reviewer #2 agreed
On 14 Nov, 2020
Reviewer #1 agreed
On 14 Nov, 2020
Reviewers invited
Invitations sent on 13 Nov, 2020
Editor assigned
On 01 Nov, 2020
Submission checks complete
On 13 Oct, 2020
Editor invited
On 12 Oct, 2020
First submitted
On 27 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Ophthalmology.
Background: The purpose of this study is to report the safety and efficacy of pars plana (PP) glaucoma drainage devices (GDDs) with pars plana vitrectomy (PPV) using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma.
Methods: Retrospective case series of 28 eyes of 28 patients who underwent combined PP GDD and PPV between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity (BCVA), and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests.
Results: Mean IOP decreased from 22.8 mmHg to 11.4 mmHg at 1.5 years (p = 0.009), and mean medication burden decreased from 4.3 to 1.7 at 1.5 years (p = 0.009). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 ≤ IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 77.7% at 1 year and 45.8% at 1.5 years. At their last visit, four eyes (14.3%) achieved complete success with IOP reduction as above without medications, and 13 eyes (46.2%) achieved qualified success with medications. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of >2 lines. Two eyes required subsequent PPV for tube obstruction, and one eye had transient hypotony.
Conclusions: The results of pars plana GDD and vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting GDDs into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.
Figure 1
Figure 2
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