title: Experience with the Baerveldt glaucoma implant in treating neovascular glaucoma.
abstract: OBJECTIVE
  The authors present a retrospective study designed to assess the effectiveness of the Baerveldt glaucoma implant in controlling intraocular pressure (IOP) and maintaining visual function in eyes with neovascular glaucoma.
  
  
  METHODS
  The medical records of all 36 patients (36 eyes) who underwent Baerveldt glaucoma implantation for medically uncontrolled neovascular glaucoma between February 1991 and December 1992 were reviewed.
  
  
  RESULTS
  Eighteen patients received Model 350 implants, 16 received Model 500 implants, and 2 received Model 200 implants. The 12- and 18-month life-table success rates (success defined as 6 mmHg < or = final IOP < or = 21 mmHg without additional glaucoma surgery or devastating complication) were 79% and 56%, respectively. Visual acuity remained stable or improved in 10 (31%) patients. Postoperative complications included flat anterior chamber, serous choroidal detachment, and obstruction of the proximal tube tip with fibrovascular tissue, each of which occurred in four (11%) patients. Eleven (31%) patients lost light perception. There were no significant differences between the groups receiving the Model 350 and Model 500 implants with respect to life-table success rates, percentage of postoperative IOP reduction, or complication rates. Patients in the Model 500 implant group required significantly fewer antiglaucoma medications post-operatively, but also demonstrated a significantly greater mean visual acuity reduction. Better preoperative visual acuity and increased patient age were positively correlated with a successful outcome.
  
  
  CONCLUSIONS
  Baerveldt implantation is effective in controlling IOP elevation associated with neovascular glaucoma. Postoperative visual loss, despite adequate IOP control, is common. Young patient age and poorer preoperative visual acuity are significant predictors of surgical failure.
authors.affiliation: Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Sidoti
authors.forename: T R
authors.initials: TR
authors.lastname: Dunphy
authors.forename: G
authors.initials: G
authors.lastname: Baerveldt
authors.forename: L
authors.initials: L
authors.lastname: LaBree
authors.forename: D S
authors.initials: DS
authors.lastname: Minckler
authors.forename: P P
authors.initials: PP
authors.lastname: Lee
authors.forename: D K
authors.initials: DK
authors.lastname: Heuer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015355:Glaucoma, Neovascular / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D015993:Life Tables; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity