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2015 ; 160
(3
): 516-521.e2
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Glaucoma drainage devices: risk of exposure and infection
#MMPMID26032191
Levinson JD
; Giangiacomo AL
; Beck AD
; Pruett PB
; Superak HM
; Lynn MJ
; Costarides AP
Am J Ophthalmol
2015[Sep]; 160
(3
): 516-521.e2
PMID26032191
show ga
PURPOSE: To identify risk factors for device exposure and intraocular infection
following implantation of a glaucoma drainage device. DESIGN: Retrospective case
series. METHODS: The medical records of adult patients undergoing glaucoma
drainage device implantation at an academic medical center between 2000 and 2010
were reviewed. Main outcome measures included device exposure and intraocular
infection. RESULTS: Seven hundred and sixty-three cases were identified. These
included 702 primary implants (ie, the first drainage device implanted into an
eye) and 61 sequential implants. Among 702 primary implants, there were 41 cases
of exposure (5.8%). None of the potential risk factors were statistically
significant. Implant location was found to be a marginally significant risk
factor. The exposure rates for inferior and superior implants were 12.8% (5 of
39) and 5.4% (36 of 663), respectively (P = .056). The highest rate of exposure
for primary implants occurred in the inferior-nasal quadrant (17.2%, 5 of 29).
The rate of exposure for sequential devices was 13.1% (8 of 61), with the highest
rate also found in the inferior-nasal quadrant (20%, 5 of 25). Of 49 total
exposures, 8 were associated with intraocular infection (16.3%). Exposures over
inferior implants were more likely to be associated with infection than exposures
over superior implants (41.7% vs 8.1%; P = .0151). CONCLUSION: Implant location
approached, but did not reach, statistical significance as a risk factor for
exposure. Exposures over inferior implants place patients at a higher risk of
infection than superior exposures. More studies are needed to identify modifiable
risk factors for device exposure.
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