Survival in Patients with Neovascular Glaucoma Following Tube Shunt Implant or Cyclodestructive Procedure

Yujia Zhou; Sydni Coleman; Jess Boysen; Morgan L Pansegrau; Martha M Wright; Emmett F Carpel; Karen R Armbrust

doi:10.5005/jp-journals-10078-1357

Survival in Patients with Neovascular Glaucoma Following Tube Shunt Implant or Cyclodestructive Procedure

J Curr Glaucoma Pract. 2022 May-Aug;16(2):74-78. doi: 10.5005/jp-journals-10078-1357.

Authors

Yujia Zhou¹, Sydni Coleman¹, Jess Boysen¹, Morgan L Pansegrau², Martha M Wright², Emmett F Carpel², Karen R Armbrust¹

Affiliations

¹ Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, United States.
² Department of Ophthalmology, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, United States.

Abstract

Purpose: The study purpose was to assess patient survival after tube shunt implant or cyclodestructive procedure for neovascular glaucoma and to determine whether specific preoperative factors are predictive of survival.

Materials and methods: A retrospective chart review was performed on patients with neovascular glaucoma who underwent tube shunt implant and/or cyclodestructive procedure between January 2002 and December 2019 at the Minneapolis Veterans Affairs Health Care System. Patient survival was compared to the age and gender-matched Minnesota population. Cox regression analyses were performed to evaluate preoperative parameters and survival.

Results: Tube shunt alone was implanted in 30 eyes, cyclodestruction alone was performed in nine eyes, and two eyes underwent both (n = 41 eyes, 39 patients). The postoperative 5-year survival rate was 62% in neovascular glaucoma patients compared to 80% in controls. Survival did not differ significantly based on neovascular glaucoma etiology. Preoperative best-corrected visual acuity of the neovascular glaucoma-affected eye (p = 0.05) and Charlson Comorbidity Index (p = 0.02) were associated with survival, but preoperative maximum intraocular pressure, hemoglobin A1c, and creatinine were not. The mean intraocular pressure at 6 months postprocedure was 14 mm Hg for tube shunt and 27 mm Hg for cyclodestruction (p = 0.03).

Conclusion: Neovascular glaucoma patients have reduced survival, but the majority survived at least 5-year postprocedure. Ophthalmologists should consider patient survival and factors predictive of survival when planning procedures for neovascular glaucoma.

Clinical significance: Our findings provide an updated perspective on survival in the setting of neovascular glaucoma and can help ophthalmologists provide patient-centered and holistic care.

How to cite this article: Zhou Y, Coleman S, Boysen J, et al. Survival in Patients with Neovascular Glaucoma Following Tube Shunt Implant or Cyclodestructive Procedure. J Curr Glaucoma Pract 2022;16(2):74-78.

Keywords: Cyclodestruction; Glaucoma drainage implants; Neovascular glaucoma; Retrospective cohort study; Survival analysis.