Outcome of Baerveldt glaucoma drainage implants for the treatment of uveitic glaucoma☆
Received 20 August 2001; accepted 26 February 2002.
Abstract
Objective
To evaluate the efficacy and safety of Baerveldt glaucoma drainage devices in the management of uveitic glaucoma.
Design
Retrospective, noncomparative case series.
Participants
Twenty-four eyes of 24 patients who underwent implantation of Baerveldt glaucoma drainage devices between 1996 and 2000 for the treatment of uveitic glaucoma refractory to medical therapy.
Intervention
Implantation of Baerveldt glaucoma drainage device.
Main outcome measures
Control of intraocular pressure (IOP), number of glaucoma medications needed for adequate IOP control, visual acuity, complications associated with the surgery, and the effect of subsequent surgery on the ability of the device to control IOP. Success was defined as IOP ≥5 and ≤21 mmHg with or without antiglaucoma medications and without need for further glaucoma surgery, loss of light perception, or phthisis.
Results
Cumulative life-table success rates were 95.8% at 3 months and 91.7% at 6 months, 12 months, and 24 months. The mean postoperative follow-up was 20.8 months. The IOP was reduced from a preoperative mean of 30.5 ± 8.96 mmHg with 3.1 ± 0.99 antiglaucoma medications to a postoperative mean at 6 months or 1 year of 13.0 ± 4.6 mmHg (P < 0.001) with 0.8 ± 0.8 antiglaucoma medications (P < 0.001). At last follow-up 14 of 24 eyes (58.3%) required no antiglaucoma medications. Best-corrected visual acuity improved or remained within 2 lines of preoperative visual acuity in 19 (79.2%) eyes. The most common complications were choroidal effusions in four (16.7%), hypotony in three (12.5%) eyes, cystoid macular edema in three (12.5%) eyes, and failure of corneal grafts in two (8.3%). Seven of 22 eyes (31.8%) in which successful control of IOP with the Baerveldt implant was achieved underwent subsequent nonglaucoma-related incisional surgery. None of these eyes (0%) lost IOP control after the subsequent procedure.
Conclusions
The Baerveldt glaucoma drainage device offers reasonable safety and effectiveness for the control of IOP in eyes with uveitis and refractory glaucoma.
aDepartment of Ophthalmology, University of Miami School of Medicine, Bascom Palmer Eye Institute, Miami, Florida, USA
Correspondence to Richard K. Parrish, MD, Department of Ophthalmology, 900 NW 17th St., Miami, Florida 33136, USA.
ABSTRACT