Long-term Outcomes of a Modified Technique Using the Baerveldt Glaucoma Implant for the Treatment of Refractory Glaucoma

Long-term Outcomes of a Modified Technique Using the Baerveldt Glaucoma Implant for the Treatment of Refractory Glaucoma

PURPOSE OF THE STUDY:The purpose of the study was to evaluate the long-term effectiveness and safety profile of Baerveldt glaucoma implant (BGI) in patients with refractory glaucoma operated using a modified technique to avoid postoperative complications. PATIENTS AND METHODS:A total of 160 eyes fro...

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Bibliographic Details
Published in:Journal of glaucoma Vol. 25; no. 12; pp. 952 - 958
Main Authors: Marchini, Giorgio, Ceruti, Piero, Vizzari, Gabriele, Toscani, Marco, Amantea, Camilla, Tosi, Roberto, Marchetti, Pierpaolo
Format: Journal Article
Language:English
Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-12-2016
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Filtering Surgery - methods
Follow-Up Studies
Glaucoma - physiopathology
Glaucoma - surgery
Glaucoma Drainage Implants
Humans
Intraocular Pressure - physiology
Middle Aged
Postoperative Period
Time Factors
Tonometry, Ocular
Treatment Outcome
Visual Acuity
Young Adult
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Summary:PURPOSE OF THE STUDY:The purpose of the study was to evaluate the long-term effectiveness and safety profile of Baerveldt glaucoma implant (BGI) in patients with refractory glaucoma operated using a modified technique to avoid postoperative complications. PATIENTS AND METHODS:A total of 160 eyes from 147 glaucomatous patients were enrolled in a consecutive interventional noncomparative case series. All the patients were treated with a 350-mm BGI using a modified technique. Intraocular pressure (IOP), the number of medications, the complications, and the postoperative interventions were reported preoperatively and during the follow-up. Postoperative IOP and the rate of complications were the primary outcome measures. The complete and qualified surgical success was the second endpoint. RESULTS:BGI obtained a mean IOP reduction from 31.8±6.4 mm Hg (baseline) to 14.4±3.5 mm Hg after a mean follow-up period of 38.4±9.6 months. The mean number of medications reduced between preoperative (n=3.17±1.03) and postoperative period (n=0.58±0.83) (P<0.0001). Cumulative probability of maintaining an IOP between 5 and 21 mm Hg and/or a 25% or greater reduction in IOP was 78.7% at 1 year and 72.1% at 4 years, including 39 eyes (24.4%) in which postoperative interventions were required (qualified success). If we exclude those eyes from the analysis, the probability of complete success was 93.4% at 1 year and 91.4% at 4 years in 75.4% of the eyes. CONCLUSIONS:This modified technique achieved a high percentage of surgical success during the whole follow-up time and was effective in preventing the most serious immediate complications of nonvalved tube shunts.
Bibliography:ObjectType-Article-1
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ISSN:1057-0829
1536-481X
DOI:10.1097/IJG.0000000000000488