LAUSR

PURPOSE To compare the 2-year outcomes of eyes that underwent the Aurolab aqueous drainage implant (AADI) with and without a scleral patch graft. DESIGN Retrospective comparative interventional case series. METHODS Eyes with AADI and a minimum of 2-year follow-up were included. Eyes operated before January 2016 had surgery with scleral patch graft covering the distal end of the tube while those after this period underwent surgery using a needle generated scleral tunnel without the patch graft. The cumulative failure of the AADI was defined as intraocular pressure (IOP)>18 mm Hg or not reduced by 30% below baseline on two consecutive follow-up visits after 3 months. RESULTS We included 215 adult eyes (n=147 with patch graft, n=68 without patch graft) and 111 pediatric eyes (n=73 with patch graft, n=38 without patch graft). The mean IOP in eyes without the patch graft was higher at 1 month in adult eyes (27.5 + 14.1 vs. 22.3 + 11.1, p=0.01) but not in pediatric eyes (14.3 + 5.8 vs. 17.8 + 11.0, p=0.39); there were no differences in IOP, vision, number of antiglaucoma medications and complications between groups at all other time points. None of the eyes without the patch graft experienced tube exposure. Cumulative success at 2-years was similar in adults (66.2 vs. 63.9%, p=0.85) and children (77.2% vs. 71.9%, p=0.83) with both techniques. CONCLUSIONS The AADI placed without a scleral patch graft is an equally safe and effective option compared to AADI with a patch graft in pediatric and adult refractory glaucomas.