Reintervention rate in glaucoma filtering surgery: A systematic review and meta-analysis

Abstract

Purpose Reintervention rate is an important factor impacting on patients, surgeons, and society. To date, only a few studies have focused on this topic. For this reason, a systematic review and meta-analysis was undertaken to assess the reintervention rate after glaucoma filtering surgery. Materials and Methods Prospective studies reporting the reintervention rate after glaucoma filtering surgery and with at least 12 months of follow-up were systematically searched on PubMed, Medline and Embase databases. The primary outcome was the total reintervention rate following surgery. Secondary outcomes were: the rate of manipulation, in-clinic and in-operating room reintervention; the reintervention rate for intraocular pressure (IOP) control and for complications; demographic, clinical and surgical variables associated with reintervention rate. Results Ninety-three studies with a total of 8345 eyes were eligible. The total reintervention rate was 1.84 (95% CI 1.57–2.13), with a lower rate for Baerveldt (0.53, 95% CI 0.29–0.83) and Preserflo (0.60, 95% CI 0.15–1.29), and a higher rate for Xen (4.26, 95% CI 2.59–6.31). The manipulation rate was 0.99 (95% CI 0.77–1.23), the in-clinic reintervention rate was 0.08 (95% CI 0.05–0.12) and the in-operating room reintervention rate was 0.28 (95% CI 0.22–0.35). The reintervention rate for IOP control was 1.26 (95% CI 1.04–1.51) and the reintervention rate for complications was 0.27 (95% CI 0.21–0.35). Conclusions All types of surgery presented a total reintervention rate similar to the overall findings, except studies on Baerveldt and Preserflo Microshunt, with a lower rate, and Xen, with a higher rate. None of the variables evaluated were found to be directly associated with the explored outcomes.