Intermediate-Term Outcomes of Affordable Aqueous Drainage Implant in Refractory Glaucoma

Saturday, April 18, 2015: 3:36 PM
Room 1B (San Diego Convention Center)
George V. Puthuran, MS
Paul F. Palmberg, MD, PhD
Alan L. Robin, MD
Steven J. Gedde, MD
Krishna Das, MS

Purpose
AADI (Aurolab Aqueous Drainage Implant ) is a non - valved aqueous shunt and is a potential solution to the cost barrier of glaucoma drainage devices in developing countries. The objective of the study was to determine the intermediate- term outcomes of AADI implantation in refractory glaucoma.

Methods
This is a prospective, noncomparative, interventional case series of 30 eyes of 30 patients who underwent AADI implantation for refractory glaucoma at a tertiary eye care hospital in South India.  The main outcome measures were intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), surgical complications, and success (IOP ≥ 5 mmHg and ≤ 21 mm Hg with or without glaucoma medications, reduction of IOP by ≥ 20% from baseline, no loss of light perception, and no need for additional glaucoma surgery). Patients were followed for at least 18 months post surgery.

Results
Surgical success at 18 months was 97%. IOP reduced from mean (± SD) of 31.77 (± 8.2) mm Hg preoperatively to 14.07 (± 3.5) mm Hg at 18 months follow up (56% reduction, p < 0.001). Number of antiglaucoma medications reduced from mean (± SD) of 2.67 (± 0.7) preoperatively to mean 1.1 (± 0.9) 18 months postoperatively (p < 0.001). The median BCVA did not show any statistically significant change at final follow up visit from preoperative level. Postoperative complications included choroidal detachment (n = 3), corneal decompensation (n = 3), and tube retraction (n = 1).

Conclusion
Aurolab aqeous drainage implants are a safe and effective treatment to provide IOP control in patients with refractory glaucoma.