Purpose: To analyze the long-term postoperative results of tube shunt surgery for exfoliation glaucoma and to examine its safety.
Methods: We retrospectively examined 22 consecutive cases (24 eyes) treated at the Kumamoto University Hospital from 2012 to 2017. The follow-up period was 33.0±19.1 months (mean±standard deviation), and preoperative intraocular pressure was 28.9±7.2 mmHg. Seventeen of the eyes had a history of cataract surgery, and all cases had a history of filtration surgery. Simultaneous cataract surgery was performed on two eyes.
Results: Postoperative intraocular pressure significantly decreased to 14.6±4.0, 13.1±2.9, 13.3±4.2, and 12.3±2.8 mmHg at 1 year, 2 years, 3 years, and 4 years, respectively, compared to those before surgery. The one-year survival rate was 91.7% based on the life table analysis, which defined cases maintaining the intraocular pressure of 5 to 20 mmHg with or without glaucoma instillation as successful. Early complications were observed in 17 eyes (70.8%). Major complications observed were choroidal detachment, hypotony, anterior chamber/vitreous hemorrhage, and disappearance of the anterior chamber. Late complications were observed in 7 eyes (29.1%), the main complications of which were hypotony and corneal endothelial dysfunction.
Conclusion: While Baerveldt^Ⓡ tube shunt surgery for exfoliative glaucoma is effective for lowering intraocular pressure, caution should be exercised regarding complications.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 125: 111-116, 2021.