Simultaneous placement of 2 glaucoma drainage devices for uncontrolled glaucoma.
OBJECTIVE
To report baseline characteristics and surgical outcomes of placement of simultaneous glaucoma drainage devices (GDDs) in eyes with considerably elevated intraocular pressure (IOP) despite maximal medical therapy.


METHODS
Retrospective case series.


METHODS
Twelve eyes of 12 patients underwent simultaneous placement of a Baerveldt 350 GDD and an Ahmed S3 GDD in the same eye.


METHODS
The medical records were reviewed of consecutive patients who underwent simultaneous placement of a Baerveldt 350 GDD and an Ahmed S3 GDD in the same eye at the University of Michigan Kellogg Eye Center from 2006 to 2009. Baseline characteristics, preoperative and postoperative IOP, number of glaucoma medications, visual acuity, and complications were recorded.


RESULTS
Mean follow-up time was 28.6 ± 22.8 months. The mean baseline cup/disc ratio was recorded at 0.94 ± 0.07 horizontally and 0.92 ± 0.09 vertically. The mean baseline IOP of 38.8 ± 6.2 mm Hg was significantly reduced at all time points postoperatively, and the mean IOP at last follow-up was 15.1 ± 4.9 mm Hg (p ≤ 0.0001). Mean number of glaucoma medications was significantly lower at last follow-up than preoperatively (1.4 ± 1.3 vs 3.2 ± 0.8; p = 0.001). There was no difference in mean logMAR visual acuity from before surgery to last follow-up (1.14 vs 1.12; p = 0.933).


CONCLUSIONS
Simultaneous placement of 2 GDDs effectively reduces IOP in the immediate postoperative period and long-term, and may be useful in glaucomatous eyes with advanced disease and considerably elevated preoperative IOP.
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Mich.
Anna C
AC
Momont
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Mich.
Joshua D
JD
Stein
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Mich.
Paul P
PP
Lee
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Mich. Electronic address: jweizer@med.umich.edu.
Jennifer S
JS
Weizer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D000959:Antihypertensive Agents