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

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.