title: Practice preferences for glaucoma drainage device implantation and cyclodestruction in Australia and New Zealand.
abstract: OBJECTIVE
  To evaluate the practice patterns in the use of glaucoma drainage devices (GDD) and cyclodestruction among consultant ophthalmologists in Australia and New Zealand.
  
  
  METHODS
  A 22-part questionnaire regarding GDD implantation and cyclodestruction practices was sent to all ophthalmologists registered with the Royal Australian and New Zealand College of Ophthalmologists in 2008 by post or e-mail.
  
  
  RESULTS
  Sixty-six percent of 872 questionnaires were returned, of these, 14% were from glaucoma subspecialists. Ten percent of all respondents performed GDD implantations. Molteno drains were the most popular device (69%). The most commonly recognized indications for GDD implantation were a history of 2 failed trabeculectomies (85%), neovascular glaucoma (71%), iridocorneal endothelial syndrome (55%), and uveitic glaucoma (52%). Only a minority of surgeons used intraoperative mitomycin C (38%) or 5-fluorouracil (26%) when implanting GDD. Cyclodestruction had been performed by 20% of all respondents. External diode cyclophotocoagulation was the most preferred treatment mode (73%). Sixty-seven percent treated 180 degrees of the ciliary body during initial treatment. Fifty-five percent treated only the earlier untreated area during retreatment. Only 11% of surgeons who performed cyclodestruction agreed that the indications for cyclodestruction are expanding.
  
  
  CONCLUSIONS
  A wide range of practice patterns for GDD implantation and cyclodestruction exist among Australian and New Zealand ophthalmologists. This likely reflects a paucity of good evidence to guide practice. The Australasian indications for GDD implantation were moderately different from the reported practice in America. Well-designed clinical trials are needed to better define the indications and best practice for these 2 important glaucoma treatment modalities.
authors.affiliation: Department of Ophthalmology, Waikato Hospital, Hamilton, New Zealand. drkentchow@gmail.com
authors.forename: Kent
authors.initials: K
authors.lastname: Chow
authors.forename: Justin
authors.initials: J
authors.lastname: Mora
mesh_terms: D001315:Australia / Q000453:epidemiology; D002924:Ciliary Body / Q000601:surgery*; D005901:Glaucoma / Q000453:epidemiology / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D017075:Laser Coagulation / Q000706:statistics & numerical data*; D054023:Lasers, Semiconductor; D009520:New Zealand / Q000453:epidemiology; D009885:Ophthalmology / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D019919:Prosthesis Implantation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires