■ Although short-term overall success rates were high with either a second glaucoma drainage device (GDD) or transscleral cyclophotocoagulation (CPC) in eyes with inadequately controlled IOP, a second GDD was linked to more clinic visits and an increased risk of more glaucoma surgery. Writing in the Journal of Glaucoma, researchers said that both treatments were reasonable options for eyes with inadequately controlled IOP after a single GDD.
The randomized study was undertaken in 42 eyes at 14 clinical centers. Surgical failure was defined as: (1) IOP ≤5 mmHg or >18 mmHg or <20% reduction below baseline on maximum tolerated topical ocular hypotensive therapy, (2) reoperation for glaucoma, or (3) loss of light perception. The primary outcome measure was overall success with or without adjunctive medical therapy.
Mean follow-up was 18.6 months and the cumulative success rate at 1 year was 79% for second GDD and 88% for CPC (P=.63). The number of additional glaucoma surgeries (P=.003), office visits during the first 3 months (P<.001), and office visits per month after month 3 (P<.001) were greater in the second GDD group.