Five-Year Efficacy and Safety of the Susanna Glaucoma Drainage Device

Précis: The Susanna Glaucoma Drainage Device achieved sustained 5-year IOP and medication reduction, with a 80.9% success rate and a favorable safety profile, supporting its effectiveness for long-term management of refractory glaucoma. Purpose: To evaluate the 5-year outcomes of the Susanna Glaucoma Drainage Device for the treatment of glaucoma. Patients and Methods: Medical records from consecutive patients aged 18 years or older with glaucoma who underwent implant surgery with the Susanna Glaucoma Drainage Device from January 2017 to January 2020 were included. The primary outcome was success, defined as IOP ≥6 and <18 mm Hg and the absence of loss of light perception or additional glaucoma surgery. Secondary outcomes included IOP, hypotensive therapy, adverse events, and surgical interventions. Results: A total of 104 patients were included; the mean patient age was 60.8±17.6 years. The mean preoperative IOP was 29.9±11.6 mm Hg, with 2.8±0.9 glaucoma medications. At 5 years, the cumulative success rate was 80.9%. IOP and medication use were significantly reduced at all postoperative visits. At 5 years, mean IOP was 13.4±3.6 mm Hg (55.2% reduction, P <0.001), and mean medication use was 1.9±1.4 (32.1% reduction, P <0.001). The primary reason for failure was elevated IOP (38.9%). Five patients underwent glaucoma reoperation to lower IOP; 2 cases were treated with cyclophotocoagulation, while 3 underwent a second SGDD inferiorly. Hypotony-related failure was observed in 1 case. Among the failures, 5 patients developed significant vision loss. Conclusions: The Susanna implant effectively reduced IOP and medication dependence over 5 years. It demonstrated a high success rate (80.9%) and sustained pressure control. These findings support the long-term efficacy of the Susanna implant in managing refractory glaucoma.