RESUMEN
OBJECTIVE: To study the intermediate-term results of glaucoma drainage devices (DDG) with respect to control of intraocular pressure (IOP), control of glaucoma, and maintenance of pre-operative visual acuity. METHODS: This was a retrospective cohort study of 86 eyes in 77 patients in whom a DDG was implanted, using descriptive statistics and survival analysis. RESULTS: Success was achieved in 53 eyes (61.6%), complete (without treatment) in 34 eyes (39.5%) and qualified (needing treatment) in 19 eyes (22.1%). In the 33 eyes where the DDG treatment was unsuccessful, poor IOP control occurred in 13 eyes - (15.1%), and complications occurred in 20 eyes (23.2%) resulting in a severe reduction or loss of visual acuity (plate exposure, suprachoroidal hemorrhage, retinal detachment). IOP control was obtained in 66 eyes (76.7%), 47 of them without treatment (54.6%), although on 13 occasions the overall treatment failed due to complications occurring. Despite IOP control, glaucoma progression occurred in 7 eyes (8.1%). Preoperative vision was maintained in 46 eyes (53.5%), but decreased by 3 or more lines in 20 eyes (46.5%); bullous kerathopathy was the most frequent cause of the worsening. Loss of light perception occurred in 21 eyes (24.4%) and 4 eyes (4.6%) were eviscerated. CONCLUSIONS: DDG are an effective surgical option for control of IOP when conventional surgery has a poor prognosis, but they are associated with an increased risk of serious complications and loss of visual acuity in a significant proportion of cases.
Asunto(s)
Implantes de Drenaje de Glaucoma , Glaucoma/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Objetivos: Analizar los resultados a medio plazo de los dispositivos de drenaje para glaucoma (DDG) en cuanto a control de la presión intraocular (PIO), del glaucoma y del mantenimiento de la visión preoperatoria. Métodos: Estudio de cohortes retrospectivo de 86 ojos de 77 pacientes en los que se ha implantado un DDG. Se ha empleado estadística descriptiva y análisis de supervivencia. Resultados: Se han considerado como éxito 53 ojos (61,6%), completo (sin tratamiento) en 34 ojos (39,5%); y relativo (con tratamiento) en 19 ojos (22,1%). Las causas de fracaso han sido: mal control de la PIO en 13 ojos - (15,1%), y complicaciones en 20 ojos (23,2%) con reducción severa o pérdida de visión (extrusión del reservorio, hemorragia supracoroidea, desprendimiento de retina). Se ha obtenido control de la PIO en 66 ojos (76,7%), en 47 de ellos sin tratamiento (54,6%), aunque 13 de estos han sido fracasos por complicaciones. A pesar del control de la PIO, en siete ojos (8,1%) se ha observado progresión del glaucoma. En cuanto a la visión, en 46 ojos (53,5%) se ha mantenido estable y en 40 ha disminuido 3 o más líneas (46,5%), siendo la causa más frecuente la descompensación correvisioneal. En 21 ojos (24,4%) se ha perdido la percepción de la luz, y cuatro ojos (4,6%) han sido eviscerados. Discusión: Los DDG son una opción quirúrgica eficaz para el control de la PIO en ojos con mal pronóstico para la cirugía convencional de glaucoma, pero presentan complicaciones graves y deterioro visual en un porcentaje elevado de casos
Objective: To study the intermediate-term results of glaucoma drainage devices (DDG) with respect to control of intraocular pressure (IOP), control of glaucoma, and maintenance of pre-operative visual acuity. Methods: This was a retrospective cohort study of 86 eyes in 77 patients in whom a DDG was implanted, using descriptive statistics and survival analysis. Results: Success was achieved in 53 eyes (61.6%), complete (without treatment) in 34 eyes (39.5%) and qualified (needing treatment) in 19 eyes (22.1%). In the 33 eyes where the DDG treatment was unsuccessful, poor IOP control occurred in 13 eyes - (15.1%), and complications occurred in 20 eyes (23.2%) resulting in a severe reduction or loss of visual acuity (plate exposure, suprachoroidal hemorrhage, retinal detachment). IOP control was obtained in 66 eyes (76.7%), 47 of them without treatment (54.6%), although on 13 occasions the overall treatment failed due to complications occurring. Despite IOP control, glaucoma progression occurred in 7 eyes (8.1%). Preoperative vision was maintained in 46 eyes (53.5%), but decreased by 3 or more lines in 20 eyes (46.5%); bullous kerathopathy was the most frequent cause of the worsening. Loss of light perception occurred in 21 eyes (24.4%) and 4 eyes (4.6%) were eviscerated. Conclusions: DDG are an effective surgical option for control of IOP when conventional surgery has a poor prognosis, but they are associated with an increased risk of serious complications and loss of visual acuity in a significant proportion of cases