Outcomes of reimplantation of a new Glaucoma Drainage Device after explantation of an older implant from exposure-related complications

Abstract

Purpose: To describe the clinical outcome of a series of seven eyes with an explanation of an original Glaucoma Drainage Device (GDD) arising from the complication of plate exposure and consequent reimplantation of another GDD at a second setting. Methods: This was a retrospective, interventional, and non-comparative study at two tertiary eye care hospitals in eastern and southern India. Electronic medical record data of the seven eyes where a GDD was explanted and a 2nd GDD was reimplanted over October 2010 and May 2021 was analyzed. Statistical analysis was done by SPSS (ver. 26). Results: The first GDD survived for a mean of 168 days only till the plate got exposed and thereby got explanted. Possible predisposing factors noted were conjunctival and scleral thinning, ischemic conjunctiva, etc., The reimplantation surgery was technically easy in the absence of hypotony—opposite to what is reported in the literature. The final IOP (mean +/− SD) values (mm Hg) were 18.9 (+/−7.9), range = 10–30. The mean number of glaucoma medications reduced from 3.9 (+/−1.2; range, 2 to 5) after the explanation to 3.1 (+/−0.7; range, 2 to 4) after the 2nd GDD implantation, in the final follow-up. The second GDD was found to be stable till the last follow-up (mean = 1149 days). No other significant intraoperative or postoperative complications were seen. Conclusions: Reimplantation of a second GDD in a separate setting after explanations of an original implant due to exposure-related complication is both a safe and effective method.

Keywords

• explanation
• exposure related complication
• glaucoma drainage device
• reimplantation