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Change in Humphrey Visual Field (HVF) and Optical coherence tomography (OCT) after the Tube shunt implantation with 3-Year Follow-up

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Posterboard#: A0640

Abstract Number: 2476 - A0640

AuthorBlock: Qian Liu1,2, Lijuan Huang1, Min Fu1, Joey Hsia1, Robert L. Stamper1, Ying Han1
1University of California, California, United States; 2Henan Eye Institute, California, United States;

DisclosureBlock: Qian Liu, None; Lijuan Huang, None; Min Fu, None; Joey Hsia, None; Robert L. Stamper, None; Ying Han, None;

Purpose
To determine the change in Humphrey visual field (HVF) and spectral domain optical coherence tomography (SD-OCT) after tube-shunt surgery in glaucomatous eyes over 3 years.

Methods
A retrospective chart review for consecutive adult patients who underwent tube shunt implantation from January 2014 to December 2015 was conducted. Intraocular pressure (IOP); Mean Deviation (MD) and Pattern Standard Deviation (PSD) from HVF; average retinal nerve fiber layer (RNFL), superior RNFL, inferior RNFL, average Ganglion Cell Complex (GCC), superior GCC, and inferior GCC from SD-OCT were compared between preoperative and postoperative 1-, 2- and 3-year follow-up using ANOVA and paired t-Test.

Results
A total of 110 eyes from 97 patients with an average age of 70.03±14.58 years were included in the study with 49.48% of males. Ahmed valve placement was the majority tube shunt device (91.43%). Fifty-two out of 110 (47.3%) eyes were pseudophakic. Final IOP at 3-year follow up were 13.51±4.67 mmHg, significantly decreased from the preoperative IOP of 22.24±8.36 mmHg (P<0.01). Mean preoperative MD and PSD were -10.64±8.096 dB and 7.32±3.69, respectively. Average RNFL and GCC were 72.52±15.14 µm and 77.31±15.93, respectively. When comparing to preoperative data as a group, there was no significant difference in any of the HVF and SD-OCT parameters at postoperative 1-, 2-, and 3-year follow-up (all P>0.05, ANOVA). When comparing to preoperative data within each subject, paired t-test showed that mean MD significantly decreased by -2.13±-5.38 dB at postoperative 1-year follow-up (P=0.03), but subsequently recovered back to baseline by postoperative 2-year follow-up (P=0.16). To explore the mechanism, we examined HVF MD changes based on preoperative lens status. For eyes with preoperative phakic status, MD were significantly decreased by -2.59±-4.08 dB (P=0.01), while there was no significant difference for eyes with preoperative pseudophakic status (P=0.052) at 1-year follow-up. No significant changes were found in other HVF or SD-OCT parameters in the paired comparisons.

Conclusions
Tube-shunt surgery is effective in stabilizing HVF and OCT in glaucomatous eyes over 3-year follow-up. Patient may experience transient HVF MD decrease in early postoperative period, which could be due to postoperative cataract formation.

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