title: Outcomes Disparities between Black and White Populations in the Surgical Management of Glaucoma.
abstract: African descent is a well-documented risk factor for glaucoma development, progression, and medical and surgical failure. We reviewed the literature for evidence of outcomes disparities between Black and White populations after trabeculectomy, Ex-PRESS shunt, viscocanalostomy, canaloplasy, tube shunt, laser trabeculoplasty, and cyclophotocoagulation. There are reports of decreased surgical success in Black patients after trabeculectomy, Ex-PRESS shunt, tube-shunt, and canaloplasty. At this time, there is no strong evidence that any procedure is more effective for intraocular pressure control than standard trabeculectomy for Black patients. Furthermore, there is insufficient evidence to recommend any particular secondary intervention over another, despite differences in inflammation and bleb-dependence. There is a need for randomized, controlled trials to assess race as a risk factor for failure after non-penetrating filtration surgery (NPFS). There is also a need for data on the efficacy of minimally invasive glaucoma surgery (MIGS) in Black populations.
authors.affiliation: a Vanderbilt Eye Institute , Vanderbilt University School of Medicine , Nashville , TN , USA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Taubenslag
authors.affiliation: a Vanderbilt Eye Institute , Vanderbilt University School of Medicine , Nashville , TN , USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kammer
mesh_terms: D044383:Black People; D002924:Ciliary Body / Q000601:surgery; D005901:Glaucoma / Q000208:ethnology* / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D017075:Laser Coagulation; D014130:Trabeculectomy; D044465:White People
keywords: Baerveldt tube shunt; Ex-PRESS shunt; canaloplasty; healthcare disparities; trabeculectomy