Evidence map›Paper›PMID 40962050›Full record

ArticleOphthalmology. Glaucoma

Likelihood of Corneal Transplantation after Tube versus Trabeculectomy: An IRIS® Registry Study.

Anna Marie Dickinson, Luke Leidy, Md Enamul Haque, Helene Lam, Kuldev Singh, Ann Caroline Fisher, Bethlehem Mekonnen, Suzann Pershing, IRIS® Registry Analytic Center Consortium

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Ophthalmology. Glaucoma. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Anna Marie DickinsonSpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California; Eastern Virginia Medical School, Old Dominion University, Norfolk, Virginia.
Luke LeidySpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California; Eastern Virginia Medical School, Old Dominion University, Norfolk, Virginia.
Md Enamul HaqueSpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California.
Helene LamSpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California; Ophthalmology and Eye Care Services, Surgical Service, US Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
Kuldev SinghSpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California.
Ann Caroline FisherSpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California.
Bethlehem MekonnenSpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California.
Suzann PershingSpencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California; Ophthalmology and Eye Care Services, Surgical Service, US Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Electronic address: pershing@stanford.edu.
IRIS® Registry Analytic Center Consortium

Funding

Stanford Vision Research CoreP30EY026877 · NEI · STANFORD UNIVERSITY · PI Jeffrey L Goldberg · 2017 to 2026
$8.0M
NEI NIH HHS P30 EY026877
6 · The paper itself

Abstract

objectiveUtilization of glaucoma drainage devices (tube shunts) has increased. In this analysis we evaluate long-term likelihood and time-to-event for corneal transplantation after trabeculectomy versus tube shunt glaucoma surgeries.

designRetrospective cohort study.

participantsAmerican Academy of Ophthalmology IRIS® Registry (Intelligent Research In Sight) patients who underwent glaucoma surgery between 2001 and 2021.

methodsPatients with glaucoma who underwent isolated trabeculectomy, isolated tube shunt, or both surgeries in a given eye were identified by procedure codes. Subsequent corneal transplantation procedures performed in the same eye were similarly identified. Multivariable Cox proportional hazard regression models were used to evaluate the likelihood of corneal transplantation and time from first glaucoma surgery to corneal transplantation.

main outcome measuresHazard ratios and 95% confidence intervals (CIs) for corneal transplantation.

resultsWe identified 246 521 eyes among 197 910 patients with glaucoma surgery meeting study inclusion criteria. Corneal transplantation was most frequently observed among patients who previously underwent both trabeculectomy and tube shunt (5.00%, n = 672), followed by isolated tube shunt (2.97%, n = 3473) and isolated trabeculectomy (0.80%, n = 929). Eyes that only underwent tube shunts had a mean time to corneal transplantation of 2.49 years (standard deviation [SD], 2.4), compared with 3.75 years (SD, 3.3) for isolated trabeculectomy eyes and 3.21 years (SD, 2.6) for eyes that received both trabeculectomy and tube shunt. Adjusted likelihood of corneal transplantation was highest with both trabeculectomy and tube shunt (hazard ratio [HR], 5.88; 95% CI, 5.34-6.48), and isolated tube shunt (HR, 3.97; 95% CI, 3.69-4.26), compared with isolated trabeculectomy.

conclusionsThe likelihood of corneal transplantation is over 4 times higher after tube shunts compared with trabeculectomies. This may reflect factors such as chronic, cumulative corneal endothelial mechanical trauma from the tube shunt, changes to aqueous humor fluid circulation, altered aqueous humor composition and associated signaling pathways, differences in use of antimetabolites as adjunctive therapy, tube material, and tube movement or migration over time. Further research is needed to understand causes of corneal compromise, and consideration of corneal health is warranted in glaucoma surgical decision-making. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Indexed as

Corneal TransplantationGlaucomaGlaucoma Drainage ImplantsIntraocular PressureRegistriesTrabeculectomyAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesCorneal transplantationGlaucomaIRIS RegistryTrabeculectomyTube shunt

Identifiers

PMID40962050
PMCPMC13384190

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.