Outcomes Disparities between Black and White Populations in the Surgical Management of Glaucoma

ABSTRACT

African descent is a well-documented risk factor for glaucoma development, progression, and medical and surgical failure. We reviewed the literature for evidence of outcomes disparities between Black and White populations after trabeculectomy, Ex-PRESS shunt, viscocanalostomy, canaloplasy, tube shunt, laser trabeculoplasty, and cyclophotocoagulation. There are reports of decreased surgical success in Black patients after trabeculectomy, Ex-PRESS shunt, tube-shunt, and canaloplasty. At this time, there is no strong evidence that any procedure is more effective for intraocular pressure control than standard trabeculectomy for Black patients. Furthermore, there is insufficient evidence to recommend any particular secondary intervention over another, despite differences in inflammation and bleb-dependence. There is a need for randomized, controlled trials to assess race as a risk factor for failure after non-penetrating filtration surgery (NPFS). There is also a need for data on the efficacy of minimally invasive glaucoma surgery (MIGS) in Black populations.

Keywords:

• Baerveldt tube shunt
• canaloplasty
• Ex-PRESS shunt
• healthcare disparities
• trabeculectomy

DECLARATION OF INTEREST

Jeffrey A. Kammer, M.D., is a consultant for Iridex. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.