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  • Title: Outcome of Surgical Management of Glaucoma Following Complex Retinal Detachment Repair With Silicone Oil Tamponade: Drainage Implant Versus Cyclophotocoagulation.
    Author: Albahlal A, Alshamrani A, Khandekar R, Malik R.
    Journal: J Glaucoma; 2020 Mar; 29(3):198-204. PubMed ID: 31913222.
    Abstract:
    UNLABELLED: PRéCIS:: Glaucoma drainage devices (GDDs) are effective for the management of silicone oil-induced glaucoma. Although cyclophotocoagulation (CPC) has the advantage of shorter operative time and repeatability, it carries a higher risk of failure, blindness, and phthisis. BACKGROUND/AIMS: To compare the surgical outcome of GDD implantation and diode laser CPC in the management of refractory glaucoma following vitrectomy with silicone oil (SO) injection. MATERIALS AND METHODS: In total, 56 eyes with refractory glaucoma after SO tamponade that underwent either CPC or GDD implantation were retrospectively evaluated. All patients underwent a complete ophthalmic examination and intraocular pressure (IOP) measurement at baseline and 1 day, 1 week, 1, 3, 6, and 12 months postoperatively. The rates of complete success and qualified success (for IOP between ≥5 and ≤21 mm Hg) were analyzed. RESULTS: A total of 17 eyes underwent GDD implantation and 39 eyes underwent CPC. The preoperative IOP was 35.7±7.9 mm Hg and 27.8±8.4 mm Hg for the CPC and GDD groups, respectively (P=0.001), with a worse baseline visual acuity (P=0.01) and a higher proportion of SO-filled eyes in the CPC group (P<0.01). The IOP at 1 year postoperatively was 23.5±11.5 mm Hg and 15.3±5.9 mm Hg for the CPC and GDD group, respectively (P=0.01). Both groups achieved a reduction in IOP and number of medications at 1 year (P<0.001). The success rate in the GDD group was 94.1% (16/17), and 53.8% (21/39) in the CPC group at 12 months (P<0.005). Five eyes and 1 eye lost light perception vision in the CPC and GDD groups, respectively. CONCLUSIONS: GDD implantation may carry a higher surgical success rate than CPC. However, CPC retains the advantage of being technically easier and repeatable.
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