Dataset Information

Risk factors for exposure of glaucoma drainage devices: a retrospective observational study.

ABSTRACT:

Objectives

The purpose of this study was to identify risk factors for exposure of glaucoma drainage devices (GDD).

Setting

This retrospective, observational study was conducted in the eye clinic of an academic medical centre.

Participants

Participants included 1073 consecutive adults who underwent GDD surgery between 1 January 2005 and 1 January 2011. Participants were included if chart review indicated GDD surgery during the study period and excluded if at least 12 months of clinical follow-up was not available in the medical record.

Primary outcome measure

The primary outcome measure was exposure of the GDD occurring at least 1 month after implant surgery. The characteristics of participants who experienced exposure of the implant were compared to the characteristics of participants who did not experience exposure.

Results

Of the 1073 participants having undergone GDD surgery, 67 experienced exposure of the device. Neither the type of GDD, type of patch graft (eye bank sclera, Tutoplast sclera and Tutoplast pericardium), surgeon, location of GDD, number of GDD previously implanted into the eye, nor history of diabetes or uveitis were associated with likelihood of exposure. Women were more likely than men to experience exposure of the GDD (OR 2.004 (95% CI1.170 to 3.431)) in both univariable (p=0.011) and multivariable (p=0.013) analyses. In survival analysis, exposure of the GDD occurred earlier for women than for men (58 vs 61 months; p=0.024).White race (vs black) was also associated with increased risk of GDD exposure (OR 1.693 (95% CI 1.011 to 2.833)) in univariable (p=0.044) and multivariable (p=0.046) analyses.

Conclusions

Women are two times more likely to experience GDD exposure than men, independent of age. White race is also a risk factor for exposure.

SUBMITTER: Muir KW

PROVIDER: S-EPMC4025471 | biostudies-literature | 2014 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Risk factors for exposure of glaucoma drainage devices: a retrospective observational study.

Muir Kelly W KW Lim Annie A Stinnett Sandra S Kuo Anthony A Tseng Henry H Walsh Molly M MM

BMJ open 20140502 5

<h4>Objectives</h4>The purpose of this study was to identify risk factors for exposure of glaucoma drainage devices (GDD).<h4>Setting</h4>This retrospective, observational study was conducted in the eye clinic of an academic medical centre.<h4>Participants</h4>Participants included 1073 consecutive adults who underwent GDD surgery between 1 January 2005 and 1 January 2011. Participants were included if chart review indicated GDD surgery during the study period and excluded if at least 12 months ...[more]

PMID: 24793249

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Project description:PurposeReport factors associated with failure and complication in a cohort of children who have undergone glaucoma drainage device (GDD) implantation.DesignRetrospective case series.ParticipantsConsecutive pediatric GDD eyes that met criteria between May 1997 and July 2019.MethodsEntries were included for analysis if age <18 years at the time of GDD implantation. Failure was defined as an intraocular pressure (IOP) greater than 21 mmHg or IOP reduction <20% or IOP <5 mmHg at 2 consecutive follow-up visits >3 months after implantation, reoperation for glaucoma, or loss of light perception vision. Complications were defined as postoperative events due to the GDD that required additional examination under anesthesia or additional surgery.Main outcome measuresSurvival analyses of surgical failures and complications.ResultsOver a mean follow-up period of 5.4 years, 58 (38%) of 150 first-time GDD implants failed. Glaucoma associated with acquired conditions had decreased risk for failure when compared with glaucoma secondary to nonacquired systemic diseases (hazard ratio [HR], 12; P = 0.0063), nonacquired ocular anomalies (HR, 12; P = 0.0054), and primary congenital glaucoma (HR, 5.4; P = 0.041). There was an increased risk of failure for first-time tubes in younger patients with a 23% reduction of failure with each 3-year increase in age (HR, 0.77; P = 0.034). A total of 38 (25.3%) of the first-time GDD implantations had a complication. Higher preoperative IOP (5 mmHg increase; HR, 1.2; P = 0.038) and younger age (<3 years; HR, 2.1; P = 0.024; < 2 years, HR, 1.9; P = 0.046) increased the risk of complication. There were 22 second-time GDD implants in the study, of which 11 failed (50%), and increased risk for failure was associated with younger age at the time of implantation (<1 year; HR, 27; P = 0.0053) and concurrent glaucoma-related procedures with or without non-glaucoma anterior segment surgery at the time of implantation (HR, 13; P = 0.0085).ConclusionsAlthough GDD implantation in children is relatively safe and effective, these data should be interpreted in the context of children's relative longevity. These findings offer an outcome metric to which future novel glaucoma procedures in children can be compared.

Project description:Background: The risk factors for adverse events of Coronavirus Disease-19 (COVID-19) have not been well described. We aimed to explore the predictive value of clinical, laboratory and CT imaging characteristics on admission for short-term outcomes of COVID-19 patients. Methods: This multicenter, retrospective, observation study enrolled 703 laboratory-confirmed COVID-19 patients admitted to 16 tertiary hospitals from 8 provinces in China between January 10, 2020 and March 13, 2020. Demographic, clinical, laboratory data, CT imaging findings on admission and clinical outcomes were collected and compared. The primary endpoint was in-hospital death, the secondary endpoints were composite clinical adverse outcomes including in-hospital death, admission to intensive care unit (ICU) and requiring invasive mechanical ventilation support (IMV). Multivariable Cox regression, Kaplan-Meier plots and log-rank test were used to explore risk factors related to in-hospital death and in-hospital adverse outcomes. Results: Of 703 patients, 55 (8%) developed adverse outcomes (including 33 deceased), 648 (92%) discharged without any adverse outcome. Multivariable regression analysis showed risk factors associated with in-hospital death included ? 2 comorbidities (hazard ratio [HR], 6.734; 95% CI; 3.239-14.003, p < 0.001), leukocytosis (HR, 9.639; 95% CI, 4.572-20.321, p < 0.001), lymphopenia (HR, 4.579; 95% CI, 1.334-15.715, p = 0.016) and CT severity score > 14 (HR, 2.915; 95% CI, 1.376-6.177, p = 0.005) on admission, while older age (HR, 2.231; 95% CI, 1.124-4.427, p = 0.022), ? 2 comorbidities (HR, 4.778; 95% CI; 2.451-9.315, p < 0.001), leukocytosis (HR, 6.349; 95% CI; 3.330-12.108, p < 0.001), lymphopenia (HR, 3.014; 95% CI; 1.356-6.697, p = 0.007) and CT severity score > 14 (HR, 1.946; 95% CI; 1.095-3.459, p = 0.023) were associated with increased odds of composite adverse outcomes. Conclusion: The risk factors of older age, multiple comorbidities, leukocytosis, lymphopenia and higher CT severity score could help clinicians identify patients with potential adverse events.

Dataset Information

Risk factors for exposure of glaucoma drainage devices: a retrospective observational study.

Objectives

Setting

Participants

Primary outcome measure

Results

Conclusions

Publications

Risk factors for exposure of glaucoma drainage devices: a retrospective observational study.

Similar Datasets

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