title: Endoscopic cyclophotocoagulation versus second glaucoma drainage device after prior aqueous tube shunt surgery.
abstract: BACKGROUND
  To evaluate the efficacy in controlling intraocular pressure (IOP) with endoscopic cyclophotocoagulation (ECP) versus implantation of a second glaucoma drainage device (GDD-2) in the treatment of uncontrolled glaucoma with a prior aqueous tube shunt.
  
  
  METHODS
  A nonrandomized retrospective chart review.
  
  
  METHODS
  Patients with refractory glaucoma following a failed initial tube shunt (Baerveldt Glaucoma Implant 350), who underwent ECP or GDD-2 with Baerveldt Glaucoma Implant as a second surgery. Twenty-five eyes underwent ECP, and 48 eyes received a GDD-2.
  
  
  METHODS
  ECP or second tube-shunt surgery.
  
  
  METHODS
  Reduction in IOP and antiglaucoma medications, and Kaplan-Meier survival with success defined as lOP ≥ 5 mmHg and ≤ 21 mmHg and ≥ 20% reduction from preoperative IOP. Secondary outcome measures were visual acuity and the presence of any postoperative complications.
  
  
  RESULTS
  Both ECP and GDD-2 significantly lowered IOP (Student's t test) and number of antiglaucoma medications (Wilcoxon paired signed rank test). There were no significant differences in postoperative IOP (Student's t test) or antiglaucoma medications (Mann Whitney test) between ECP and GDD-2 at 6 and 12 months. There was also no difference in the Kaplan-Meier survival outcomes between the two groups.
  
  
  CONCLUSIONS
  Both ECP and GDD-2 are both effective as second surgeries for refractory glaucoma that has failed a prior aqueous shunt.
authors: Department of Ophthalmology, University of California San Francisco, School of Medicine, San Francisco, California, USA.
authors: Yohko
authors: Y
authors: Murakami
authors: Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors: Handan
authors: H
authors: Akil
authors: Department of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors: Jasdeep
authors: J
authors: Chahal
authors: Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.|Department of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors: Laurie
authors: L
authors: Dustin
authors: Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors: James
authors: J
authors: Tan
authors: Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors: Vikas
authors: V
authors: Chopra
authors: Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors: Brian
authors: B
authors: Francis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000502:physiology; D002924:Ciliary Body / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012086:Reoperation; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
keywords: aqueous tube shunt; endoscopic cyclophotocoagulation; glaucoma drainage device; refractory glaucoma