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April 1992

Clinical Risk Factors for Failure in Glaucoma Tube Surgery: A Comparison of Three Tube Designs

Author Affiliations

From Manchester (England) Royal Eye Hospital (Dr Lavin); St Thomas's Hospital, London, England (Mr Wormald); Institute of Preventive Ophthalmology, London (Dr Franks); and Moorfields Eye Hospital, London (Dr Hitchings).

Arch Ophthalmol. 1992;110(4):480-485. doi:10.1001/archopht.1992.01080160058030

• We studied a cohort of 165 eyes that had undergone tube implant surgery for glaucoma, with a minimum follow-up of 12 months (range, 12 to 72 months). Of the 57 cases (34.5%) in which surgery failed to control intraocular pressure (less than 22 mm Hg), 15 (26%) occurred by 3 months, 36 (63%) by 12 months, and 46 (80%) by 24 months. Cox regression modeling was used to evaluate independent risk factors in the absence of additional therapy. The use of a two-piece (anterior chamber—to—encircling band) tube system was associated with a 2.4 times higher risk of failure (P<.001) compared with a one-piece system. Neovascular glaucoma was associated with a 2.1 times higher risk of failure (P<.037) than other types of glaucoma. Late failure of tube implant surgery is common and there is a steady attrition rate over a 2-year follow-up period.

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