Comparing Ahmed-FP7 to Baerveldt-250 and Baerveldt-350 surgical outcomes: 1-year results from a retrospective cohort study leveraging the electronic health record

BMJ OPEN OPHTHALMOLOGY(2023)

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摘要
ObjectiveTo compare outcomes following Ahmed-FP7 (AGI-FP7), Baerveldt-250mm(2) (BGI-250), or Baerveldt-350mm(2) (BGI-350) implantation. Methods and analysisRetrospective cohort study comprising 800 eyes from 800 individuals who underwent surgery 1 January 2016-31 December 2020 at a tertiary-care institution. Data were extracted from standardised fields in the electronic health record. Primary outcome was failure (defined as intraocular pressure (IOP) & LE;5 mm Hg or >18 mm Hg or reduction <20% at two consecutive visits from month 3 onwards; or visual acuity (VA) loss & GE;3 lines; or return to the operating room (OR)). Secondary outcomes were IOP, VA, number of follow-up visits and return to the OR. ResultsA total of 523 AGI-FP7, 133 BGI-250 and 144 BGI-350 cases were analysed. The AGI-FP7 group was more likely to be younger and diagnosed with secondary glaucoma, with a higher mean baseline IOP (28.5 & PLUSMN;12.2 vs 22.0 & PLUSMN;7.7 mm Hg in BGI-250 and 23.4 & PLUSMN;9.0 in BGI-350, p<0.001). Cumulative failure rate at month 12 was 30% (AGI-FP7) vs 39% (BGI-250) vs 33% (BGI-350, p=0.159). Mean IOP at month 12 was lower in the BGI-350 group compared with AGI-FP7 (12.4 & PLUSMN;4.4 vs 14.8 & PLUSMN;5.6 mm Hg, p=0.003) but not BGI-250 (vs 13.1 & PLUSMN;4.6, p=0.710). Target IOP was achieved in 71% of AGI-FP7, 66% BGI-250, and 76% BGI-350. VA loss and rates of return to the OR did not differ between groups. Both BGI-250 and BGI-350 had more follow-up visits than AGI-FP7 (p<0.001). ConclusionThese three glaucoma drainage devices performed similarly within 1 year, with no difference in failure rates despite differing baseline patient characteristics.
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关键词
surgical outcomes,retrospective cohort study,cohort study
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