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Baerveldt implant in refractory glaucoma: long-term results and factors influencing outcome

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Abstract

Purpose: To evaluate the clinical outcome of patients who received aBaerveldt implant for refractory glaucoma and to identify factors which mayinfluence the outcome. Methods: Retrospective study including 51 eyesof 51 patients with medically uncontrolled glaucoma who underwent Baerveldtimplant surgery between June 1994 and December 1998. Criteria for successwere intraocular pressure (IOP) ≤ 21 mmHg and >6 mmHg, necessityof further antiglaucoma medications, absence of additional glaucoma surgeryand no loss of light perception. Results: Over a mean follow-up of 37.6(SD: ± 18.8) months, the mean intraocular pressure decreased from 34.8(±12.5) mmHg to 14.0 (±4.3) mmHg at month 60. Qualified successrate, achieved when IOP was below 21 mmHg and higher than 6 mmHg withmedications was 25/48 (52%), complete success rate (same IOP limits withoutmedication) was 14/48 (29%). Seven eyes had major complications or lostlight perception. Postoperative visual acuity improved or remained within oneSnellen line of the preoperative visual acuity in 35 patients (73%). Factorsassociated with a better prognosis were a preoperative visual acuity better than 20/400 and etiology of glaucoma. Conclusion: The Baerveldt implant iseffective in lowering intraocular pressure in most patients with refractoryglaucoma. Long-term results are promising with satisfactory IOP control.

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References

  1. Molteno AC, Staughan L, Anker E. Long tube implants in the management of glaucoma. S Afr Med J 1976; 50: 1062-1066.

    Google Scholar 

  2. Schocket SS, Nirankari VS, Lakhanpal V, et al. Anterior chamber tube shunt to an encircling band in the treatment of neovascular glaucoma and other refractory glaucomas: a long-term study. Ophthalmology 1985; 92: 553-562.

    Google Scholar 

  3. Hitchings RA, Lavin MJ, Clathorpe M. Glaucoma drainage tubes-their role in glaucoma management. Int Ophthalmol 1989; 13: 151-157.

    Google Scholar 

  4. Prata JA Jr, Mermoud A, LaBree L, Minckler DS. In vitro and in vivo flow characteristics of glaucoma drainage implants. Ophthalmology 1995; 102: 894-904.

    Google Scholar 

  5. Lloyd MAE, Baerveldt G, Heuer DK, Minckler DS, Martone JF. Initial clinical experience with the Baerveldt implant in complicated glaucomas. Ophthalmology 1994; 101: 640-650.

    Google Scholar 

  6. Varma R, Heuer DK, Lundy DC, Baerveldt G, Lee PP, Minckler DS. Pars plana Baerveldt tube insertion with vitrectomy in glaucomas associated with pseudophakia and aphakia. Am J Ophthalmol 1995; 119: 401-407.

    Google Scholar 

  7. Siegner SW, Netland PA, Urban RC, et al. Clinical experience with the Baerveldt glaucoma drainage implant. Ophthalmology 1995; 102: 1298-1307.

    Google Scholar 

  8. Hodkin MJ, Goldblatt WS, Burgoyne CF, Ball SF, Insler MS. Early clinical experience with the Baerveldt implant in complicated glaucomas. Am J Ophthalmol 1995; 120: 32-40.

    Google Scholar 

  9. Lloyd MAE, Baerveldt G, Fellenbaum PS, et al. Intermediateterm results of randomized clinical trial of the 350-versus the 500-mm2 Baerveldt implant. Ophthalmology 1994; 101: 1456-1464.

    Google Scholar 

  10. Molteno AC. New implant for drainage in glaucoma: clinical trial. Br J Ophthalmol 1969; 53: 606-615.

    Google Scholar 

  11. Molteno AC. The optimal design of drainage implants for glaucoma. Trans Ophthalmol Soc NZ 1981; 33: 39-41.

    Google Scholar 

  12. Williams AS. Setons in glaucoma surgery. In: Albert DM, Jakobiec FA (eds) Principles and Practice of Ophthalmology: Clinical Practice. Philadelphia: WB Saunders, 1994; 1655-1667.

    Google Scholar 

  13. Lloyd MAE, Minckler DS, Heuer DK, et al. Echographic evaluation of glaucoma shunts. Ophthalmology 1993; 100: 919-927.

    Google Scholar 

  14. Melamed S, Cahane M, Gutman I, Blumental M. Postoperative complications after Molteno implant surgery. Am J Ophthamol 1991; 111: 319-322.

    Google Scholar 

  15. McDonnell PJ, Robin JB, Schanzlm DJ, et al. Molteno implant for control of glaucoma in eyes after penetrating keratoplasty. Ophthalmology 1988; 95: 364-369.

    Google Scholar 

  16. Mermoud A, Salomon JF, Alexander P, Straker C, Murray ADN. Molteno tube implantation for neovascular glaucoma. Ophthalmology 1993; 100: 897-902.

    Google Scholar 

  17. Minckler DS, Heuer DK, Hasty B, et al. Clinical experience with the singleplate Molteno implant in complicated glaucoma. Ophthalmology 1988; 95: 1181-1188.

    Google Scholar 

  18. Downes RN, Flanagan DW, Jordan K, Burton RL. The Molteno implant in intractable glaucoma. Eye 1988; 2: 250-259.

    Google Scholar 

  19. Smith MF, Doyle JW, Sherwood MB. Comparison of the Baerveldt glaucoma implant with the double-plate Molteno drainage implant. Arch Ophthalmol 1995; 113: 444-447.

    Google Scholar 

  20. Krupin T, Kaufmann P, Mandell Al, et al. Long-term results of valve implants in filtering surgery for eyes with neovascular glaucoma. Am J Ophthalmol 983; 95: 775-782.

  21. Sidoti PA, Dunphy TR, Baerveldt G, et al. Experience with the Baerveldt glaucoma implant in treating neovascular glaucoma. Ophthalmology 1995; 102: 1107-1118.

    Google Scholar 

  22. Nguyen QH, Budenz DL, Parrish RK. Complications of Baerveldt glaucoma drainage implants. Arch Ophthalmol 1998; 116: 571-575.

    Google Scholar 

  23. Munoz M, Parrish RK. Strabismus following implantation of Baerveldt drainage devices. Arch Ophthalmol 1993; 111: 1096-1099.

    Google Scholar 

  24. Ball SF, Ellis GS Jr, Herrington RG, Liang K. Brown's superior oblique tendon syndrome after Baerveldt glaucoma implant [letter]. Arch Ophthalmol 1992; 110: 1368.

    Google Scholar 

  25. Smith SL, Starita RJ, Fellmann RL, Lynn JR. Early clinical experience with the Baerveldt 350-mm2 glaucoma implant and associated extraocular muscle imbalance. Ophthalmology 1993; 100: 914-918.

    Google Scholar 

  26. Prata JA Jr, Santos RCR, LaBree Laurie, Minckler DS. Surface area of glaucoma implants and perfusion flow rates in rabbit eyes. J Glaucoma 1995; 4: 274-280.

    Google Scholar 

  27. Ayyala RS, Zurakowski D, Smith JA, et al. A clinical study of the Ahmed glaucoma valve implant in advanced glaucoma. Ophthalmology 1998; 105: 1968-1976.

    Google Scholar 

  28. Brooks SE, Dacey MP, Lee MB, Baerveldt G. Modification of the glaucoma drainage implant to prevent early postoperative hypertension and hypotony: a laboratory study. Ophthalmic Surg 1994; 25: 311-316.

    Google Scholar 

  29. Strum J, Postelmans L, Deflorenne C, Huyghe P, Libert J. The Baerveldt implant in refractory glaucoma: clinial results. Bull Soc Beige Ophtalmol 1997; 267: 169-174.

    Google Scholar 

  30. Britt MT, LaBree LD, Lloyd MA, Minckler DS, Heuer DK, Baerveldt G, Varma R. Randomized clinical trial of the 350-mm2 versus the 500-mm2 implant: longer term results: is bigger better? Ophthalmology 1999; 106: 2312-2318.

    Google Scholar 

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Authors and Affiliations

  1. Hôpital Ophtalmique Jules Gonin, University of Lausanne, Switzerland

    Sylvain Roy, Emilie Ravinet & André Mermoud

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  1. Sylvain Roy
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  2. Emilie Ravinet
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  3. André Mermoud
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Roy, S., Ravinet, E. & Mermoud, A. Baerveldt implant in refractory glaucoma: long-term results and factors influencing outcome. Int Ophthalmol 24, 93–100 (2001). https://doi.org/10.1023/A:1016335313035

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  • DOI: https://doi.org/10.1023/A:1016335313035

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