Long-term outcomes of Aurolab aqueous drainage implant in adults with refractory glaucoma

To report long-term outcomes of Aurolab aqueous drainage implant (AADI) surgery in adults with refractory glaucoma.

Retrospective, non-comparative, interventional case series.

Case records of patients aged >18 years who underwent AADI surgery between 2012 and 2018 and had >5 years of follow-up were reviewed. Intraocular pressure (IOP), visual acuity, number of IOP-lowering medications, complications and reoperations were recorded at baseline and at 1 day, 1 month, 3 months, 6 months, 1 year and annually thereafter. Failure was defined as IOP>21 mmHg or reduced<20% below the baseline, IOP≤5 mmHg, reoperation for glaucoma or a complication or loss of light perception vision.

The study included 282 eyes from 282 patients. Age (mean±SD) was 45.2±12.3 years, and 191 (68%) were men. Secondary angle closure glaucoma was the most common aetiologic group (30%), followed by secondary open angle glaucoma (25%) and primary open angle glaucoma (22%). IOP (mean±SD) decreased from 33.1±10.4 mmHg at baseline to 16.5±6.5 mmHg at 5 years. The cumulative probability of failure was 34.4% (95% CI 29.2 to 40.3) at 5 years. Corneal endothelial decompensation was the most common complication occurring in 32 eyes (11%). Delayed hypotony was seen in only four eyes (1.4%). After adjusting for age, sex and previous trabeculectomy, eyes with secondary glaucoma had a 32% lower risk of failure (HR=0.68, 95% CI 0.50 to 0.94, p=0.02).

The AADI showed good control of IOP over 5 years, but corneal endothelial decompensation remains a concern.