Experience with assessment of surgeons' preferences in the choice of drainage implants for glaucoma surgery

PURPOSE. To examine the professional preferences of surgeons that influence the selection of drainage devices in glaucoma surgery.

METHODS. The working hypothesis suggested that the choice of drainage for glaucoma surgery may be influenced by subjective criteria, i.e., the "professional preferences" of ophthalmic surgeons. The study involved a descriptive cross-sectional retrospective survey of 21 ophthalmic surgeons from 8 different clinics who practice drainage surgery for glaucoma. They were asked to subjectively choose the optimal method from the commonly used drainage implants in Russia. Respondents answered standardized open-ended questions. Some questions focused on surgeons' attitudes toward different drainage implants used in Russia (resorbable, partially resorbable, and non-resorbable types).

RESULTS. The resorbable drainage Glautex TDA (by HiBiTech LLC) was selected as the drainage of choice by 6 (28.5%) surgeons. The partially resorbable MP drainage (by OOO Makmedi) and the resorbable drainage Xenoplast (by OOO Transkontakt) were chosen by 3 (14%) surgeons each. Ahmed valve was preferred by 4 (19%), Ex-PRESS shunt by 2 (9.5%), and autologous implants by 2 (9.5%): autologous sclera by 1 (4.8%) and anterior lens capsule by 1 (4.8%).

CONCLUSION. The most commonly chosen drainage device was Glautex, but 71.5% of the surgeons had other preferences. The working hypothesis was confirmed. The survey results should be considered personal preferences, not a medical consensus on the problem of glaucoma surgery. A comparative, objective analysis of the advantages of one drainage over another based on this simple survey is not possible, as the method does not provide reliable primary results. The surveyed surgeons currently do not have a consensus on the optimal drainage device for glaucoma surgery. Their practices differ significantly, and they did not report reliable data on long-term surgical outcomes. The perspectives and preferences expressed could only be obtained through an anonymized survey.

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