Practice Patterns In Glaucoma Surgeries: Survey Results Of Canadian Glaucoma Society Specialists
Published 2024 - 42nd Congress of the ESCRS
Reference: FP03.12 | Type: Free paper | DOI: 10.82333/5940-2378
Authors: Biana Dubinsky-Pertzov 1 , Enitan Sogbesan* 2
1Ophthalmology,McMaster University ,Hamilton,Canada;Ophthalmology,Shamir Medical Center, Tel-Aviv University,Tel-Aviv,Israel, 2Ophthalmology,McMaster University ,Hamilton,Canada
Purpose
There is a known lack of consensus on the use of antifibrotic, anti-inflammatory, and antibiotic agents intraoperatively and postoperatively in glaucoma surgeries, especially in filtering and tube shunt procedures. This study evaluated the surgical practice patterns and the use of antifibrotic, anti-inflammatory, and antibiotic agents among glaucoma specialists in Canada.
Setting
Canadian Glaucoma Society - Online Survey
Methods
A questionnaire comprising 24 questions was distributed to the glaucoma subspecialist members of the Canadian Glaucoma Society. This questionnaire inquired about the use of Mitomycin C (MMC) in filtering procedures and tube surgeries, the routine practice of postoperative injection of antifibrotics and needling in bleb-based and tube surgeries, as well as the standard use of steroids and antibiotics both intraoperatively and postoperatively.
Results
A total of 36 Canadian glaucoma subspecialists completed the survey (40% response rate). Clinically significant variations in practice were found in the use of MMC in tube shunts, with the application of MMC during Ahmed glaucoma valve (AGV) surgery by 22% of specialists. 8.3% routinely inject antifibrotic subconjunctivally in the implant area during the ostoperative period. In bleb-based procedures, 60% inject antifibrotic into the bleb postoperatively, not as part of bleb needling. Periocular steroid injection is performed by 37%, 40%, and 42% of respondents in tube surgeries, trabeculectomy, and bleb-based procedures, respectively. In glaucoma surgeries alone, 56% of respondents do not inject intracameral antibiotics.
Conclusions
Our study highlights the significant variability among Canadian glaucoma specialists in their use of antifibrotic agents intra and postoperatively specifically in tube and filtration surgeries This variability emphasizes the need for multicentered research to assess the outcomes of these diverse techniques, which could then lead to the development of standardized guidelines to optimize surgical outcomes and patient care.