Low cost drainage device use in paediatric glaucoma
Reviewed by Jonathan Chan

This is a prospective study from a tertiary referral centre from India of 34 eyes (31 patients) under 16 years with uncontrolled refractory glaucoma with medical treatment. A low cost glaucoma drainage device (GDD) – Aurolab aqueous drainage implant (ADDI), similar to Baeveldt glaucoma implant (BGI) was evaluated. The mean follow-up was 18.3 +/- 6.9 months and the mean IOP reduction was from 27.4mmHg on maximum medication to 14.6mmHg, 13.8, 12.8 and 14.7mmHg at one week, six months, one year (32 eyes) and two years (25 eyes) postoperatively, respectively (p<0.001). The mean number of medications decreased from 3.1 to 1.8 and to 1.6, at six and 24 months respectively (p<0.001). The cumulative probability of success was 91.8% and 81.7% at six and 12-24 months respectively. Twenty-five patients needed systemic acetazolamide preoperatively and decreasing to three patients postoperatively. One eye developed retinal detachment. In the first week, four patients had transient hyphaema and two had transient hypotony. At three months, two patients required trimming of the drainage tube and one child required repositioning of the tube position due to tube-corneal touch. One child required resuturing of the retracted conjunctiva. One child had cataract surgery at six months. There was no tube erosion or infection. The authors concluded that the ADDI device is a viable low-cost GDD option with similar effectiveness and safety profile comparable to BGI or Ahmed glaucoma valve drainage device in children. The limitations of the study include the non-homogenous group of patients different types of glaucoma, non-uniform earlier treatment, small cohort of the study group and relatively short-term follow-up period.

Safety and efficacy of a low–cost glaucoma drainage device for refractory childhood glaucoma.
Kaushik S, Kataria P, Raj S.
BRITISH JOURNAL OF OPHTHALMOLOGY
2017;101:1623-7.