title: Analysis of long-term outcomes for combined pars plana vitrectomy (PPV) and glaucoma tube shunt surgery in eyes with advanced glaucoma.
abstract: OBJECTIVE
  To analyze 12- and 24-month visual acuity, intraocular pressure, and complications associated with combined pars plana vitrectomy (PPV) and glaucoma tube shunt placement in eyes with glaucoma.
  
  
  METHODS
  A retrospective chart review was performed of patients with advanced glaucoma who underwent combined PPV and tube shunt surgery from 2006 to 2010. A minimum of 12 months of follow-up was required for their inclusion in the study. Visual acuity, intraocular pressure, complications, and number of glaucoma medications at 1 and 2 years postoperatively were analyzed.
  
  
  RESULTS
  Twenty-eight eyes met the inclusion and exclusion criteria. Baseline visual acuity was 20/200 or worse in 14/28 eyes (50.0%) and 20/40 or better in 2/28 eyes (7.1%). Visual acuity remained 20/200 or worse in 50.0% (P=0.921) and 44.4% (P=0.973) of eyes after 1 and 2 years postoperatively, respectively. At baseline, the mean intraocular pressure was 30.4 mm Hg. There was significant improvement in mean IOP at 1 year (14.7 mm Hg, P=0.001) and at 2 years (15.2 mm Hg, P=0.001) postoperatively. Baseline number of glaucoma medications averaged 3.0±1.09 (SD), and improved to 1.8±1.28 (SD) at 1 year (P=0.0002) and to 1.4±1.33 at 2 years (P<0.0001) postoperatively.
  
  
  CONCLUSIONS
  In this retrospective interventional case series, surgical management of advanced glaucoma with a combination of PPV and glaucoma tube shunt resulted in significantly reduced IOP and glaucoma medications at 1 and 2 years postoperatively.
authors: Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors: A
authors: A
authors: Gandhi
authors: Cincinnati Eye Institute, Cincinnati, OH, USA.
authors: D M
authors: DM
authors: Miller
authors: Cincinnati Eye Institute, Cincinnati, OH, USA.
authors: J M
authors: JM
authors: Zink
authors: Cincinnati Eye Institute, Cincinnati, OH, USA.
authors: A K
authors: AK
authors: Khatana
authors: Cincinnati Eye Institute, Cincinnati, OH, USA.
authors: C D
authors: CD
authors: Riemann
authors: Cincinnati Eye Institute, Cincinnati, OH, USA.
authors: M R
authors: MR
authors: Petersen
authors: Cincinnati Eye Institute, Cincinnati, OH, USA.
authors: R E
authors: RE
authors: Foster
authors: Cincinnati Eye Institute, Cincinnati, OH, USA.
authors: R A
authors: RA
authors: Sisk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents