Mortality following glaucoma surgery in octogenarians with primary open angle glaucoma
Aluzri, Hussain Yeo, Vanessa Suleiman, Kusy Richardson, Jay Sung, Velota
Aluzri, Hussain
Yeo, Vanessa
Suleiman, Kusy
Richardson, Jay
Sung, Velota
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Affiliation
Sandwell and West Birmingham NHS Trust
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Publication date
2025-09-26
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Abstract
Background: This study aims to quantify the mortality rate following glaucoma surgery in octogenarian patients with primary open-angle glaucoma (POAG) and identify risk factors associated with mortality in this age group. Methods: A retrospective single centre consecutive case series was conducted involving 115 patients aged 80 and over who underwent glaucoma surgery at the Birmingham Midland Eye Centre between January 2015 and December 2019. Results: The all-cause mortality incidence for patients over 80 undergoing glaucoma surgery is 66.86 deaths per 1000 person-years. On univariable analysis, pre-operative risk factors [hazard ratio [HR], 95% Confidence interval (CI)] for increased mortality include age, [1.099 (1.013, 1.192)], Clinical Frailty Score [1.250 (1.036, 1.507)], chronic obstructive pulmonary disease (COPD) [2.187 (1.252, 3.818)], dementia [2.397 (1.075, 5.343)], myocardial infarction [2.392 (1.208, 4.737)], respiratory system disease [1.974, (1.179, 3.305), and solid tumours [7.344 (2.170, 24.849)]. Visual acuity was the only ophthalmic factor significantly associated [1.745 (1.046, 2.902)] with mortality, while other glaucoma-related parameters, such as intraocular pressure and retinal nerve fibre layer thickness, were non-significant. On multi-variable analysis, Afro-Caribbean became significant [0.469 (0.224, 0.979)], and all univariable risk factors remained significant except for clinical frailty score and dementia. In terms of glaucoma surgery, cyclodiode laser is the only operation that had a significant hazard ratio [2.271 (1.083, 4.762)], likely due to selection bias of ill patients. Conclusion: The overall five-year survival rate post-surgery was 72.01%, with a nine-year survival rate of 43.30%. Clinical frailty scale should be assessed for all elderly patients considered for glaucoma surgery. Assessing systemic health in elderly patients is crucial for optimizing surgical outcomes and improving survival.
Citation
Aluzri H, Yeo V, Suleiman K, Richardson J, Sung VCT. Mortality following glaucoma surgery in octogenarians with primary open angle glaucoma. Int Ophthalmol. 2025 Sep 26;45(1):390. doi: 10.1007/s10792-025-03727-8
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Journal Article