hunt reviion veru additional tube hunt implantation after failed tube hunt urgery in refractory glaucoma

PURPOE: To compare tube hunt reviion with additional tube hunt after failed tube hunt urgery. METHOD: We identified 281 patient who underwent a primary tube hunt procedure from 1985 to 1998 at Indiana Univerity and reviewed 33 eye of 33 patient that had failed and required further urgery. hunt reviion wa performed in 12, wherea an additional hunt wa placed in 21 eye. Intraocular preure, antiglaucoma medication, viual acuity, and complication were noted. ucce wa defined a at leat a 25% reduction in intraocular preure that wa deemed clinically adequate. Qualified ucce wa defined a a 25% intraocular preure reduction but with additional medication or a ignificant reduction in medication with table intraocular preure for preoperative intraocular preure le than 21 mm Hg. REULT: Preoperative intraocular preure (mean ± 95% confidence interval) for the reviion and additional tube group were 28.8 ± 5.8 mm Hg and 29.8 ± 2.7 mm Hg (P = .73), with an average follow-up period of 25.2 month (range, 3 to 108 month) and 34.8 month (range, 6 to 84 month), repectively. Final mean intraocular preure wa 25.3 ± 6.7 mm Hg for the reviion group and 17.7 ± 3.4 mm Hg for the additional tube group (P = .037). Forty-two percent in the reviion group veru 62% in the additional tube group achieved at leat a qualified ucce (P = .30, Fiher exact tet). Corneal edema wa a common complication, epecially in the additional tube group. Limitation of thi tudy include the mall ample ize and the uneven ditribution of neovacular glaucoma between the two group (ix of 12 in the reviion group v two of 21 in the additional tube group; P = .015, Fiher exact tet). CONCLUION: Our erie howed that after failed tube hunt urgery, an additional tube hunt offer better intraocular preure control than reviion by exciion of an encapulated bleb.