Practice preferences for glaucoma drainage device implantation and cyclodestruction in Australia and New Zealand.

Abstract

PURPOSE:

To evaluate the practice patterns in the use of glaucoma drainage devices (GDD) and cyclodestruction among consultant ophthalmologists in Australia and New Zealand.

MATERIALS AND METHODS:

A 22-part questionnaire regarding GDD implantation and cyclodestruction practices was sent to all ophthalmologists registered with the Royal Australian and New Zealand College of Ophthalmologists in 2008 by post or e-mail.

RESULTS:

Sixty-six percent of 872 questionnaires were returned, of these, 14% were from glaucoma subspecialists. Ten percent of all respondents performed GDD implantations. Molteno drains were the most popular device (69%). The most commonly recognized indications for GDD implantation were a history of 2 failed trabeculectomies (85%), neovascular glaucoma (71%), iridocorneal endothelial syndrome (55%), and uveitic glaucoma (52%). Only a minority of surgeons used intraoperative mitomycin C (38%) or 5-fluorouracil (26%) when implanting GDD. Cyclodestruction had been performed by 20% of all respondents. External diode cyclophotocoagulation was the most preferred treatment mode (73%). Sixty-seven percent treated 180 degrees of the ciliary body during initial treatment. Fifty-five percent treated only the earlier untreated area during retreatment. Only 11% of surgeons who performed cyclodestruction agreed that the indications for cyclodestruction are expanding.

CONCLUSIONS:

A wide range of practice patterns for GDD implantation and cyclodestruction exist among Australian and New Zealand ophthalmologists. This likely reflects a paucity of good evidence to guide practice. The Australasian indications for GDD implantation were moderately different from the reported practice in America. Well-designed clinical trials are needed to better define the indications and best practice for these 2 important glaucoma treatment modalities.

• Authors: Kent Chow, Justin Mora
• Journal: Journal of glaucoma (J Glaucoma) Vol. 21 Issue 3 Pg. 199-205 (Mar 2012) ISSN: 1536-481X [Electronic] United States
• PMID: 22373595 (Publication Type: Journal Article)

Topics

• Australia (epidemiology)
• Ciliary Body (surgery)
• Glaucoma (epidemiology, surgery)
• Glaucoma Drainage Implants (statistics & numerical data)
• Health Care Surveys
• Humans
• Laser Coagulation (statistics & numerical data)
• Lasers, Semiconductor
• New Zealand (epidemiology)
• Ophthalmology (statistics & numerical data)
• Practice Patterns, Physicians' (statistics & numerical data)
• Prosthesis Implantation (statistics & numerical data)
• Surveys and Questionnaires