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Glaucoma Drainage Devices in Pediatric Glaucoma: A Systematic Review and Meta-Analysis
Furkan Ozer1, Hidayet Sener2, Metin Unlu2
1Department of Ophthalmology, Nevsehir State Hospital, Nevsehir, Turkey.
Seminars in Ophthalmology
|June 19, 2026
Summary
Glaucoma drainage device (GDD) implantation offers significant intraocular pressure (IOP) reduction and decreased medication needs in pediatric glaucoma. However, long-term success rates may vary by implant type and decrease over time.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Pediatric Medicine
Background:
- Pediatric glaucoma presents unique management challenges requiring effective interventions.
- Glaucoma drainage devices (GDDs) are utilized to manage refractory pediatric glaucoma.
- Evaluating the efficacy and safety of different GDDs is crucial for optimizing patient outcomes.
Purpose of the Study:
- To determine the pooled surgical success rate of GDD implantation in pediatric glaucoma.
- To assess postoperative changes in intraocular pressure (IOP) and medication burden.
- To conduct subgroup analyses based on specific GDD types.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Searched major databases (Web of Science, PubMed, Scopus, Cochrane) for eligible studies.
- Included studies with ≥10 pediatric patients, ≥3 months follow-up, reporting success, IOP, or medication outcomes.
Main Results:
- Analyzed 23 studies (1082 patients). Overall pooled success rate was 76%.
- Significant pooled IOP reduction (-16.14 mmHg) and medication reduction (-1.63).
- Subgroup success rates varied by device (AADI 70.7% to BGI 82.3%). Longer follow-up correlated with lower success.
Conclusions:
- GDD implantation is effective for IOP reduction and medication decrease in pediatric glaucoma.
- Substantial heterogeneity and declining success with longer follow-up indicate potential limitations in long-term durability.
- Outcomes require cautious interpretation, especially when comparing different GDDs.
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