title: 23-Gauge pars plana vitrectomy with pars plana Baerveldt tube placement for refractory glaucoma.
abstract: OBJECTIVE
  To describe a case series of combined 23-gauge vitrectomy and pars plana Baerveldt tube insertion for intraocular pressure (IOP) control in eyes with glaucoma resistant to maximum tolerated medical therapy and/or having failed previous IOP-lowering procedures.
  
  
  METHODS
  Eight consecutive patients (8 eyes) undergoing a combined procedure were identified and included in this study. Outcome measures included preoperative and final best-corrected visual acuity (VA), IOP, number of glaucoma medications, and complications. Changes in IOP and glaucoma medications were compared by a paired t test. A Kaplan-Meier survival curve was constructed to evaluate IOP control as a function of time.
  
  
  RESULTS
  Mean patient age was 70.9 years while the mean follow-up time was 12.1 months. Open angle glaucoma was diagnosed in 5 (68%) eyes. Six (75%) eyes were pseudophakic. All eyes received a 250-mm(2) pars plana Baerveldt tube. Vision remained the same or improved in 6 (75%) eyes. Mean preoperative IOP and number of glaucoma medications were significantly (p<0.05) reduced by the combined procedure. Visual acuity of 5 (63%) eyes improved or remained unchanged. Six (75%) eyes encountered minor complications not requiring a return to the operating room. One (13%) eye underwent drainage of hemorrhagic choroidals on postoperative day 12.
  
  
  CONCLUSIONS
  A combined 23-gauge vitrectomy and pars plana Baerveldt tube insertion could be considered a useful procedure in reducing IOP and the number of glaucoma medications in eyes with refractory glaucoma.
authors.affiliation: The Institute of Ophthalmology and Visual Science, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07013, USA.
authors.forename: Anton M
authors.initials: AM
authors.lastname: Kolomeyer
authors.forename: Robert D
authors.initials: RD
authors.lastname: Fechtner
authors.forename: Marco A
authors.initials: MA
authors.lastname: Zarbin
authors.forename: Neelakshi
authors.initials: N
authors.lastname: Bhagat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D019919:Prosthesis Implantation / Q000379:methods*; D013536:Suture Techniques; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents