Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Sep;160(3):516-521.e2.
doi: 10.1016/j.ajo.2015.05.025. Epub 2015 May 30.

Glaucoma drainage devices: risk of exposure and infection

Joshua D Levinson  1 , Annette L Giangiacomo  1 , Allen D Beck  1 , Paul B Pruett  1 , Hillary M Superak  2 , Michael J Lynn  2 , Anastasios P Costarides  3
Affiliations

Glaucoma drainage devices: risk of exposure and infection

Joshua D Levinson et al. Am J Ophthalmol. 2015 Sep.

Abstract

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.

PubMed Disclaimer

References

    1. Minckler DS, Francis BA, Hodapp EA, et al. Aqueous shunts in glaucoma: A report by the American Academy of Ophthalmology. Ophthalmology. 2008;115(6):1089–1098. - PubMed
    1. Stewart WC, Kristoffersen CJ, Demos CM, Fsadni MG, Stewart JA. Incidence of conjunctival exposure following drainage device implantation in patients with glaucoma. Eur J Ophthalmol. 2010;20(1):124–130. - PubMed
    1. Gedde SJ, Herndon LW, Brandt JD, et al. Postoperative complications in the Tube Versus Trabeculectomy (TVT) study during five years of follow-up. Am J Ophthalmol. 2012;153(5):804–814. - PMC - PubMed
    1. Wentzloff JN, Grosskreutz CL, Pasquale LR, Walton DS, Chen TC. Endophthalmitis after glaucoma drainage implant surgery. Int Ophthalmol Clin. 2007;47(2):109–115. - PubMed
    1. Al-Torbak AA, Al-Shahwan S, Al-Jadaan I, Al-Hommadi A, Edward DP. Endophthalmitis associated with the Ahmed glaucoma valve implant. Br J Ophthalmol. 2005;89(4):454–458. - PMC - PubMed

Publication types

MeSH terms