Baerveldt glaucoma implants in the management of refractory glaucoma after vitreous surgery.
OBJECTIVE
To examine the effectiveness and safety of Baerveldt glaucoma implants in eyes with refractory glaucoma following vitrectomy.


METHODS
We performed a retrospective study of a non-comparative case series of 30 eyes of 30 patients who had undergone the implantation of a Baerveldt glaucoma device. All eyes (30/30) had a minimum follow-up of 6 months, and 16/30 (53%) had a follow-up of 24 months. Surgical success was defined as intraocular pressure (IOP) < 22 mmHg on the last two follow-up visits with or without glaucoma medication and a decrease in IOP of at least 20% compared to preoperative values with or without glaucoma medication.


RESULTS
The mean IOP before implantation of a Baerveldt glaucoma device was 30 mmHg [+/- 11.4 mmHg standard deviation (SD)] with maximally tolerated medical therapy. Six months after implantation of the Baerveldt glaucoma device, the mean IOP was 17.3 mmHg (+/- 6.7 mmHg SD) and the mean number of glaucoma medications had gone down from 3.0 (+/- 0.4 SD) to 0.3 (+/- 0.3 SD). Successful outcomes were found in 24 eyes (80%). Small complications occurred in six eyes (20%): transient postoperative hypotony (17%) and tube retraction (3%). Larger complications occurred in another six eyes (20%): corneal decompensation requiring keratoplasty (7%), suprachoroidal haemorrhage (3%) and persistently high IOP (10%).


CONCLUSIONS
Baerveldt glaucoma devices are a valid treatment option in eyes with refractory glaucoma after vitreous surgery, although failure occurred in 20% of our patients. Transient complications occurred in 20% and severe complications in another 20%.
Van Aken
Elisabeth
E
Department of Ophthalmology, Service of Vitreoretinal Surgery, University Hospital Ghent, Belgium. elisabeth.vanaken@ugent.be
Lemij
Hans
H
Vander Haeghen
Yves
Y
de Waard
Peter
P
D000328:Adult; D000368:Aged; D002832:Choroid Hemorrhage / Q000209:etiology; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000009:adverse effects; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology; D015814:Ocular Hypotension / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014821:Vitrectomy / Q000009:adverse effects; D055815:Young Adult