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Glaucoma Drainage Devices: Risk of Exposure and Infection #MMPMID26032191
Am J Ophthalmol 2015[Sep]; 160 (3): 516-521.e2 PMID26032191show 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?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 (5.8%) cases of exposure. 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=0.056). 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, eight 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=0.0151). 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.