Extrusion-Free Survival Following Glaucoma Drainage Device Surgery Using EverPatch Plus^®: A Propensity Score-Weighted...

Objectives: To evaluate extrusion-free survival following glaucoma drainage device (GDD) surgery using EverPatch Plus^® (EPP) and to compare outcomes with conventional scleral patch grafts using propensity score-based survival analysis. Methods: This retrospective case series included 19 eyes that underwent GDD implantation with EPP and 105 control eyes that received conventional scleral patch grafts. To adjust for baseline differences between groups, a propensity score for EPP use was estimated using multivariable logistic regression incorporating age, neovascular glaucoma, prior glaucoma surgery, preoperative intraocular pressure, number of glaucoma medications, quadrant of patch placement, and insertion site. Stabilized inverse probability of treatment weighting was applied. Because follow-up in the EPP group did not exceed 12 months, all survival analyses were performed with administrative censoring at 12 months. Extrusion-free survival was evaluated using Kaplan-Meier analysis and Cox proportional hazards modeling. Results: Within 12 months, patch extrusion occurred in 3 of 19 eyes in the EPP group and in 12 of 105 eyes in the scleral patch graft group. After inverse probability weighting, estimated 12-month extrusion-free survival was 83.5% in the EPP group and 88.4% in the scleral patch graft group, indicating no statistically significant difference between groups (log-rank test, p = 0.498). In an inverse probability-weighted Cox model, EPP use was not significantly associated with extrusion risk (hazard ratio ≈ 1.3; 95% confidence interval ≈ 0.4-4.0). Conclusions: After adjustment for baseline covariates and restriction of follow-up to 12 months, extrusion-free survival following glaucoma drainage device surgery using EPP was comparable to that achieved with conventional scleral patch grafts.