Analysis of long-term outcomes for combined pars plana vitrectomy (PPV) and glaucoma tube shunt surgery in eyes with advanced glaucoma

作者：Gandhi A; Miller D M^*; Zink J M; Khatana A K; Riemann C D; Petersen M R; Foster R E; Sisk R A

来源：Eye, 2014, 28(3): 290-295.

DOI：10.1038/eye.2013.263

• pars plana vitrectomy
• glaucoma tube shunt
• glaucoma
• intraocular pressure

Purpose To analyze 12- and 24-month visual acuity, intraocular pressure, and complications associated with combined pars plana vitrectomy (PPV) and glaucoma tube shunt placement in eyes with glaucoma.
Patients and methods A retrospective chart review was performed of patients with advanced glaucoma who underwent combined PPV and tube shunt surgery from 2006 to 2010. A minimum of 12 months of follow-up was required for their inclusion in the study. Visual acuity, intraocular pressure, complications, and number of glaucoma medications at 1 and 2 years postoperatively were analyzed.
Results Twenty-eight eyes met the inclusion and exclusion criteria. Baseline visual acuity was 20/200 or worse in 14/28 eyes (50.0%) and 20/40 or better in 2/28 eyes (7.1%). Visual acuity remained 20/200 or worse in 50.0% (P = 0.921) and 44.4% (P = 0.973) of eyes after 1 and 2 years postoperatively, respectively. At baseline, the mean intraocular pressure was 30.4 mm Hg. There was significant improvement in mean IOP at 1 year (14.7 mm Hg, P = 0.001) and at 2 years (15.2 mm Hg, P = 0.001) postoperatively. Baseline number of glaucoma medications averaged 3.0 +/- 1.09 (SD), and improved to 1.8 +/- 1.28 (SD) at 1 year (P +/- 0.0002) and to 1.4 +/- 1.33 at 2 years (P<0.0001) postoperatively.
Conclusion In this retrospective interventional case series, surgical management of advanced glaucoma with a combination of PPV and glaucoma tube shunt resulted in significantly reduced IOP and glaucoma medications at 1 and 2 years postoperatively.

• 出版日期2014-3