Long-term outcomes of nonvalved glaucoma drainage devices in uveitic glaucoma
Abstract
Purpose: To evaluate the long-term efficacy and safety profile of nonvalved glaucoma drainage devices (GDDs) in the management of refractory uveitic glaucoma. Design: Retrospective interventional case series. Participants: Sixty-five eyes of 51 patients. Methods: Patients underwent Baerveldt (78.5%) or Molteno (21.5%) GDD implantation at a single tertiary center between 2000 and 2021. The mean follow-up period was 12.05 ± 4.9 years. Main outcome measures: Primary outcome was surgical success defined by World Glaucoma Association criteria. Secondary outcomes included intraocular pressure (IOP) control, medication burden, and complications. Results: Mean IOP decreased from 32.6 ± 8.4 mmHg preoperatively to 12.2 ± 5.2 mmHg at the last follow-up (P < 0.0001), with concurrent glaucoma medications reduction from 3.8 ± 0.8 to 0.9 ± 1.1 (P < 0.0001). At the final visit, qualified and complete success rates were 58.5% (38/65) and 33.8% (22/65), respectively. The mean survival time was 12.8 years for qualified success and 8.1 years for complete success. Failure occurred in 41.5% (27/65) of eyes, most commonly due to hypotony (13 eyes) or inadequate IOP reduction (10 eyes). Mean best-corrected visual acuity was unchanged (0.49 ± 0.53 vs 0.59 ± 0.72 logarithm of the minimum angle of resolution, P = 0.34). On multivariate analysis, Baerveldt implantation (hazard ratio [HR], 5.56; 95% confidence interval [CI], 2.20-14.09; P < 0.001) and concurrent systemic biologic therapy (HR, 28.57; 95% CI, 6.90-111.11; P < 0.001) were strong independent predictors of qualified success. Conclusions: Nonvalved GDDs offer durable IOP control and preserved vision in uveitic glaucoma, for over a decade, with 58.5% qualified success and 41.5% failure at final follow-up (12.05 ± 4.9 years). These findings represent the longest reported outcomes for this cohort. Financial disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.
Date
2025-12-16
Type
Article
Subject
Uveitis, Glaucoma, Ophthalmology
Collections
Citation
Aluzri H, Swampillai AJ, Hussain S, Masood I, Sung VCT. Long-Term Outcomes of Nonvalved Glaucoma Drainage Devices in Uveitic Glaucoma. Ophthalmol Glaucoma. 2025 Dec 16:S2589-4196(25)00252-2. doi: 10.1016/j.ogla.2025.12.005. Epub ahead of print
Journal / Source Title
Ophthalmology Glaucoma
DOI
10.1016/j.ogla.2025.12.005
PMID
41412490
Publisher
Elsevier