CLINICAL-EXPERIENCE WITH THE BAERVELDT GLAUCOMA DRAINAGE IMPLANT

Purpose: To assess clinical outcomes in patients who were treated with the Baerveldt glaucoma drainage implant. Methods: The authors perform ed a retrospective multicenter study of 100 patients (103 eyes) with m edically uncontrollable glaucomas who underwent a one-stage implantati on with either the 200-, 250-, 350-, or 500-mm(2) Baerveldt implant. T he authors defined surgical success as 5 mmHg less than intraocular pr essure less than 22 mmHg without additional glaucoma surgery and witho ut loss of light perception. Results: With a mean follow-up of 13.6 +/ - 0.9 months (range, 4-37 months), 74 eyes (71.8%) had successful outc omes. Cumulative life-table success rates were 90.3% at 3 months (n = 103), 72.6% at 6 months (n = 84), and 60.3% at 24 months (n = 34). Int raocular pressure (IOP) was reduced from a mean of 38.5 +/- 1.4 mmHg w ith 2.2 +/- 0.1 antiglaucoma medications to 15.1 +/- 0.8 mmHg (P < 0.0 005) with 0.5 +/- 0.1 antiglaucoma medications (P < 0.0005). Visual ac uity was improved or remained within one line of the preoperative visu al acuity in 90 eyes (87.4%). Complications occurred in 74 eyes (71.8% ). A significant portion of these complications (45%) was transient, r esolving without any intervention. Only 8% were serious sight-threaten ing complications. The most common complications included shallow ante rior chamber or hypotony (32%), choroidal effusion or hemorrhage (20.4 %), corneal decompensation or edema (17.5%), hyphema (14.1%), and tube obstruction (12.6%). Conclusion: The Baerveldt implant is effective i n lowering the IOP in patients with intractable glaucomas. Hypotony an d other complications are common, which also have been reported in oth er nonvalved glaucoma drainage implants. However, the majority of thes e complications did not affect surgical outcome.