Japanese journal of ophthalmology · 2025
Hypertensive phase after a novel small-lumen non-valved drainage device: predictive factors and two-year outcomes.
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Franquesa-Garcia Francesc, Labay-Tejado Sara, Ventura-Abreu Néstor, Izquierdo-Serra Jordi, Opazo-Toro Valeria, Milla Elena
Аннотация
PURPOSE: The hypertensive phase (HP) following the implantation of a glaucoma drainage device (GDD) is a clinical challenge. We aimed to evaluate the risk factors, clinical features, and correlation of the HP with efficacy in a cohort of glaucoma patients who received a Paul glaucoma implant (PGI).
STUDY DESIGN: This was a single-center retrospective cohort study (Hospital Clínic of Barcelona).
METHODS: Eighty-three eyes from 71 patients who underwent implantation of a PGI were included, with follow-up extending for up to 2 years. Intraocular pressure (IOP) was measured preoperatively, and at 1 day; 1 week; and 1, 3, 6, 12, and 24 months, postoperatively. Four different success criteria were established: criterion A: IOP <21 mm Hg; criterion B: <18 mm Hg; criterion C: <15 mm Hg; criterion D: <12 mm Hg. The numbers of postoperative IOP-lowering drops, complications, characteristics related to the presence or absence of an HP, and timing of prolene stent removal, among others, were recorded.
RESULTS: We observed a total of 23 cases (27.7% with an HP). On multivariate analysis we identified younger age (P = .028) and elevated IOP 1 month after surgery (P = .001) as independent risk factors. IOPs were significantly higher (P <.05) in the HP group at 1 week and at 1, 3, and 6 months postoperatively. After 12 months of follow-up, no differences were found between the 2 groups.
CONCLUSION: The occurrence of an HP with a PGI does not seem to impact surgical success beyond 12 months postoperatively. However, further research is needed to better understand the underlying mechanisms of HP development and its clinical impact.
STUDY DESIGN: This was a single-center retrospective cohort study (Hospital Clínic of Barcelona).
METHODS: Eighty-three eyes from 71 patients who underwent implantation of a PGI were included, with follow-up extending for up to 2 years. Intraocular pressure (IOP) was measured preoperatively, and at 1 day; 1 week; and 1, 3, 6, 12, and 24 months, postoperatively. Four different success criteria were established: criterion A: IOP <21 mm Hg; criterion B: <18 mm Hg; criterion C: <15 mm Hg; criterion D: <12 mm Hg. The numbers of postoperative IOP-lowering drops, complications, characteristics related to the presence or absence of an HP, and timing of prolene stent removal, among others, were recorded.
RESULTS: We observed a total of 23 cases (27.7% with an HP). On multivariate analysis we identified younger age (P = .028) and elevated IOP 1 month after surgery (P = .001) as independent risk factors. IOPs were significantly higher (P <.05) in the HP group at 1 week and at 1, 3, and 6 months postoperatively. After 12 months of follow-up, no differences were found between the 2 groups.
CONCLUSION: The occurrence of an HP with a PGI does not seem to impact surgical success beyond 12 months postoperatively. However, further research is needed to better understand the underlying mechanisms of HP development and its clinical impact.