Combined vitrectomy/glaucoma drainage device with posteriorly placed tubes compared to anterior chamber placed tubes in children

Compare combined vitrectomy/posterior tube placement in children to age-matched controls who underwent conventional anterior chamber glaucoma drainage device (GDD) placement. Retrospective review of children (< 18 years of age) with at least 1-year of post-operative follow-up who underwent combined vitrectomy/GDD placement (Vit/GDD) between 2010 and 2024 and age-matched controls who had conventional anterior chamber GDD placement. Demographics, ocular diagnoses and surgeries, and exam findings were collected. Main outcome measures were BCVA, IOP, and glaucoma medications, success and survival of GDD (IOP 5–21 mmHg, no additional IOP-lowering surgeries, and no visually devastating complications). Children in the Vit/GDD ( n = 45) and control ( n = 73) groups showed no difference in age at surgery, GDD-type implanted, or follow-up length. The Vit/GDD group underwent fewer prior glaucoma surgeries ( p = 0.0032), but had a higher rate of pseudophakia/aphakia ( p < 0.0001) compared to controls. The control group had better preoperative and final BCVA ( p < 0.01) than the Vit/GDD group, but there were no intergroup differences in IOP (preoperative or final) or number of glaucoma medications (preoperative or final). In both groups, the final IOP and number of glaucoma medications were significantly decreased compared to preoperative exam ( p < 0.0001). Success at final follow-up was 51% (median 4.9 years) in the Vit/GDD group and 67% (median 3.6 years) in the controls. However, survival curves were not significantly different ( p = 0.2853). In children with glaucoma, concurrent Vit/GDD placement with posterior placement of the tube and aged-matched controls who underwent conventional anterior chamber GDD placement both obtained IOP control at final follow-up. Further, there was no difference in survival rates between the two groups.