title: Long-term intraocular pressure control and corneal graft survival in eyes with a pars plana Baerveldt implant and corneal transplant.
abstract: OBJECTIVE
  To investigate long-term intraocular pressure (IOP) control and corneal graft survival in eyes with a valveless Baerveldt glaucoma drainage implant (GDI) through the pars plana (PP) and a penetrating keratoplasty (PK).
  
  
  METHODS
  We reviewed the medical records of 48 patients (51 eyes) who underwent PP placement of a GDI and a PK between July 1996 and June 2006 at the University of Virginia. The GDI was inserted during the same operation as the PK in 26 eyes (51.0%). Glaucoma control was assessed by IOP and the need for further glaucoma medication or surgery. Corneal grafts were assessed for clarity.
  
  
  RESULTS
  Mean follow-up was 38.4 months. IOP was successfully controlled in 88%, 85%, and 82% of eyes at 12, 24, and 48 months, respectively. Corneal grafts were clear in 89%, 67%, and 41% of eyes at 12, 24, and 48 months, respectively. Corneal graft failure was significantly higher in eyes with an anterior chamber intraocular lens (P<or=0.01), and in eyes with a diagnosis of chronic angle closure glaucoma (P=0.04).
  
  
  CONCLUSIONS
  PP insertion of a valveless GDI tube, in eyes with a previous or concurrent PK, is an effective way to control IOP in eyes with medically uncontrolled glaucoma.
authors.affiliation: Department of Ophthalmology, University of Virginia Health Sciences Center, Charlottesville, VA, USA. mwitmer@health.usf.edu
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Witmer
authors.forename: James S
authors.initials: JS
authors.lastname: Tiedeman
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Olsakovsky
authors.forename: Mark R
authors.initials: MR
authors.lastname: Conaway
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Prum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology