Extrusion-Free Survival Following Glaucoma Drainage Device Surgery Using EverPatch Plus^Ⓡ: A Propensity Score-Weighted Survival Analysis

Objectives: To evaluate extrusion-free survival following glaucoma drainage device (GDD) surgery using EverPatch Plus® (EPP) and to compare outcomes with conven-tional scleral patch grafts using propensity score–based survival analysis. Methods: This retrospective case series included 19 eyes that underwent GDD im-plantation with EPP and 105 control eyes that received conventional scleral patch grafts. To adjust for baseline differences between groups, a propensity score for EPP use was estimated using multivariable logistic regression incorporating age, neovascu-lar glaucoma, prior glaucoma surgery, preoperative intraocular pressure, number of glaucoma medications, quadrant of patch placement, and insertion site. Stabilized in-verse probability of treatment weighting was applied. Because follow-up in the EPP group did not exceed 12 months, all survival analyses were performed with adminis-trative censoring at 12 months. Extrusion-free survival was evaluated using Kaplan–Meier analysis and Cox proportional hazards modeling. Results: Within 12 months, patch extrusion occurred in 3 of 19 eyes in the EPP group and in 12 of 105 eyes in the scleral patch graft group. After inverse probability weighting, estimated 12-month extrusion-free survival was 83.5% in the EPP group and 88.4% in the scleral patch graft group, indicating no statistically significant difference between groups (log-rank test, P = 0.498). In an inverse probability-weighted Cox mod-el, EPP use was not significantly associated with extrusion risk (hazard ratio ≈ 1.3; 95% confidence interval ≈ 0.4–4.0). Conclusions: After adjustment for baseline covariates and restriction of follow-up to 12 months, extrusion-free sur-vival following glaucoma drainage device surgery using EPP was comparable to that achieved with conventional scleral patch grafts.