Baerveldt drainage implants in eyes with a preexisting scleral buckle

Objective: To describe the surgical insertion of a Baerveldt drainage impla nt and postoperative visual acuity and intraocular pressure (IOP) outcomes in patients with a preexisting scleral buckle. Methods: Medical records of all patients with a preexisting scleral buckle who underwent insertion of a Baerveldt drainage implant at Bascom Palmer Ey e Institute, Miami, Fla, from January 1, 1994, through December 31, 1998, w ere reviewed. Outcome measures included visual acuity and IOP at 1 year. Results: At 1 year postoperatively, 14 (88%) of 16 patients had stable or i mproved visual acuity. Preoperatively, mean IOP was 30.9 mm Hg and the mean number of antiglaucoma medications was 3.4; at 1 year postoperatively, mea n IOP was 12.0 mm Hg and the mean number of antiglaucoma medications was 0. 8 (P<.001). Nine patients (56%) achieved an IOP of greater than 5 and no gr eater than 21 mm Hg without medication, and an additional 7 (44%) achieved this level of IOP control with medication. No patient required further surg ery for uncontrolled IOP during the follow-up interval, which ranged from 1 9.1 to 45.5 months. Conclusion: Baerveldt drainage device insertion behind or over a preexistin g encircling band is often successful in managing refractory glaucoma in pa tients who have undergone previous scleral buckling procedures.