Need for Additional Glaucoma Surgery and Complications Following Glaucoma Drainage Device Surgery.

PRCIS In this longitudinal study of patients with open-angle, pseudoexfoliative, or neovascular glaucoma receiving glaucoma drainage devices, post-tube cumulative rates of reoperation, corneal graft, and visually threatening complications increased beyond 5 years and were not significantly affected by glaucoma type. PURPOSE To study the need for additional glaucoma surgery and development of complications after first glaucoma drainage device (GDD) surgery in eyes with primary open-angle (OAG), pseudoexfoliative (PXE), or neovascular (NVG) glaucoma. PATIENTS AND METHODS There were 306 eyes with OAG (n=185), PXE (n=60), or NVG (n=61) glaucoma who received a first GDD between 1996 and 2017. Outcomes including glaucoma reoperation, corneal graft procedure, and visually threatening complications (VT-complications) after GDD were measured. Kaplan-Meier analysis was used to compare cumulative rate of reaching outcomes over time after GDD placement among the three glaucoma groups. RESULTS When comparing the OAG, PXE, and NVG groups, there were no significant differences in post-GDD cumulative rates of reoperation (P=0.33), corneal graft (P=0.26), or VT-complications (P=0.65) over time. For all eyes, the overall cumulative rates for each outcome measure increased beyond 5 years, and specific Kaplan-Meier rates (5-year, 10-year) included: reoperation (16%, 25%), corneal graft (6%, 12%), visually threatening complications (9%, 14%). When comparing specific GDDs, the Ahmed FP7 had a higher cumulative reoperation rate over time compared to the Baerveldt 350 (P=0.019). CONCLUSION Glaucoma type did not significantly affect post-GDD cumulative rates of reoperation, corneal graft, and VT-complication among the OAG, PXE, and NVG groups. For all eyes, cumulative rates of reoperation, corneal graft, and VT-complications increased beyond 5 years. The Ahmed FP7 had a significantly higher cumulative reoperation rate compared to the Baerveldt 350 over time.