Low-Cost New Glaucoma Drainage Device in Indonesia: One Year Follow-Up of 252 Subjects.

Abstract

Background: To evaluate the early efficacy and safety of a new polymethyl methacrylate 200 mm² non-valved glaucoma drainage device (GDD) designed for Indonesian use over a 12 month period.

Methods: This was a prospective study following subjects with various forms of refractory glaucoma aged ≥ 7 years old followed for 12 months. The subjects had IOP measurements and biomicroscopy examination preoperatively and at 1, 3, 6 and 12 months timepoints. We noted anti-glaucoma medication use and additional interventions during follow-up. Success was defined as an IOP > 5 and ≤ 21 mmHg on no medications (complete) or medications (qualified).

Results: There were 252 subjects, 31% (79/252) primary glaucoma and 69% (173/252) secondary glaucoma. All primary glaucoma had previous surgery. The majority of secondary glaucoma was post-vitrectomy and silicone oil insertion 35.6% (62/174). The mean pre-op IOP was 36.8 ± 12.2 mmHg and the 12 months post op IOP was 14.2 ± 6.6 mmHg. The qualified success rate was 89% at 1 year and the complete success was 57%. Mean medication use dropped from 3.5 to 1.3. Certain subtypes (Silicone oil and POAG) appeared to experience greater IOP reduction, however they also had greater preoperative IOP.

Conclusion: This new GDD has comparable IOP lowering outcomes compared with other non-valved glaucoma drainage devices during 1 year follow up with similar complication rates.