Baerveldt glaucoma implant in the ciliary sulcus: midterm follow-up.
OBJECTIVE
To report the midterm clinical outcomes of a surgical technique for inserting the silicone tube of a Baerveldt glaucoma implant into the ciliary sulcus in pseudophakic patients.


METHODS
Noncomparative, interventional case series in which all glaucoma patients with uncontrolled intraocular pressure (IOP) undergoing Baerveldt glaucoma implant insertion with the silicone tube placed in the ciliary sulcus between 1998 and 2007 were enrolled. Preoperative and postoperative IOP, number of antiglaucoma medications, best-corrected visual acuity, surgical complications, and any subsequent related events or procedures were recorded.


RESULTS
A total of 17 patients (17 eyes) with a mean age of 67.5+/-15.3 (SD) years (range: 39 to 94 y) were included in the study. Mean follow-up was 37.2+/-18.9 months (range: 14 to 72 mo) and mean IOP was reduced from 28.4+/-12.2 (range: 12 to 56 mm Hg) to 12.1+/-5.9 mm Hg (range: 3 to 26 mm Hg) at the last follow-up visit (P<0.001). Eighty-two percent of the cases (14 out of 17) had an IOP between 7 and 18 mm Hg at the end of the follow-up period. The mean number of antiglaucoma medications was reduced from 3.4+/-1.4 (range: 0 to 5) to 2.0+/-1.4 (range: 0 to 4) during the same period (P=0.01). There was no statistically significant difference with respect to mean best-corrected visual acuity (logMAR) at baseline [1.3+/-1 (range: 0.2 to 3)] and at last follow-up visit [1.7+/-1.3 (range: 0.2 to 4); P=0.11]. One patient developed chronic hypotony and another patient had iris incarceration in the tube.


CONCLUSIONS
Our findings suggest that placement of a silicone tube into the ciliary sulcus in pseudophakic eyes is an effective alternative for glaucoma management with minor postoperative complications.
Department of Ophthamology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, NY, USA. tiagoprata@ig.com.br
Tiago Santos
TS
Prata
Anish
A
Mehta
Carlos Gustavo V
CG
De Moraes
Celso
C
Tello
Jeffrey
J
Liebmann
Robert
R
Ritch
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000378:metabolism*; D002924:Ciliary Body / Q000601:surgery*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure; D007910:Lenses, Intraocular; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D019591:Pseudophakia / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity