ABSTRACT NUMBER - 38

THE IMPACT OF MINIMALLY INVASIVE PROCEDURES ON GLAUCOMA SURGERY


Samantha Bobba1, Hamish Dunn1, Ebony Smith2, Karen Tiuseco1, Paul Healey1, Andrew White1

Meeting:  2018 RANZCO


SESSION INFORMATION

Date:      -

Session Title: POSTER ABSTRACT- GLAUCOMA

Session Time:      -

Purpose: Minimally invasive glaucoma surgery (MIGS) has increasingly been used for patients with glaucoma and ocular hypertension. We sought to evaluate the outcomes of MIGS use in our institution.
Methods: A retrospective audit and analysis of Xen, Cypass, Hydrus, iStent, trabeculectomies and Baerveldt tube procedures performed at Westmead Hospital between 30/3/17–30/3/18 was undertaken. Failure was defined as intraocular pressure (IOP) greater than 21 mmHg on two or more glaucoma medications and/or requiring surgical revision. IOP (without washout) was recorded preoperatively and at one day, one week, one month, three months and six months postoperatively. Complica- tions included hypotony, stent malpositioning, hyphaema, choroidal formation, stent blockage and wound leak.
Results: Over the study period, 38 trabeculectomies,
32 Xen stents, 23 Hydrus, 19 Cypass, 18 Baerveldt tubes and 14 iStent operations were performed. A reduction in IOP and number of glaucoma medications required postoperatively was observed for all proce- dures, with greater pressure reduction after Baerveldt tubes (48.6%) and trabeculectomies (40.5%) compared with Hydrus (27.2%) and iStents (20.4%). Failure rates were highest for Xen stents (31.0%), followed by tubes (11.1%), trabeculectomies (7.9%), Cypass (5.2%), Hydrus (4.3%) and iStents (0%). Total compli- cation rates varied substantially for tubes (38.8%), Xen stents (21.9%), trabeculectomies (15.8%), Hydrus (8.7%), iStents (7.1%) and Cypass (5.2%). Conclusion: Whilst external drainage procedures led to greater absolute and percentage decline in IOP compared with Cypass, Hydrus and iStents, they were also associated with substantially higher

complication rates. Longer term follow-up is required to fully assess the risks and benefits of MIGS procedures.