Two-staged Baerveldt glaucoma implant for childhood glaucoma associated with Sturge-Weber syndrome

Purpose: To report the outcome and complications of 10 eyes of 9 children w ith Sturge-Weber syndrome (SWS) who underwent two-stage insertion of a Baer veldt glaucoma implant (BGI) for glaucoma. Design: Retrospective noncomparative case series. Participants: The authors reviewed the medical records of children under th e age of 14 years with SWS who underwent two-stage BGI for glaucoma at two tertiary care referral centers, Main Outcome Measures: Intraoperative and postoperative complications, intr aocular pressure (IOP), number of glaucoma medications, visual acuity, and further surgical intervention, Results: Ten eyes of nine patients were included in the study. Ages of the nine patients at time of first stage BGI ranged between 6 weeks and 13 year s. With average follow-up of 35 months (range, 10-50), all eyes had adequat e IOP control (less than or equal to 21 mmHg) without the need for addition al glaucoma surgery. Intraocular pressure was reduced from a mean (+/- stan dard deviation) of 24.8 +/- 6.2 mmHg preoperatively to 16.9 +/- 2.3 mmHg at last follow-up visit (P = 0.001). The number of medications used for contr ol of glaucoma was reduced from a mean (+/- standard deviation) of 1.8 +/- 1.0 preoperatively to 1.1 +/- 1.4 at last follow-up visit (P = 0.2). One ey e had serous choroidal effusions with overlying serous retinal detachment t hat resolved spontaneously after 7 days with no permanent visual loss, and one eye had low choroidal effusion that lasted 4 days. There were no intrao perative or postoperative suprachoroidal hemorrhages, At last follow-up, vi sual acuity had improved by one or more lines in all patients in whom visio n was measurable, Conclusions: Two-stage BGI surgery appears to be a safe and effective treat ment for refractory glaucoma in children with SWS, Ophthalmology 2000;107:2 105-2110 (C) 2000 by the American Academy of Ophthalmology.