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J. C. Meier, S. L. Hoki, J. C. Song; Single Stage Baerveldt Valve in the Treatment of Childhood Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3958.
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To evaluate the short term safety and efficacy of single-stage Baerveldt valves in the treatment of childhood glaucoma.
A retrospective review of all single-stage Baerveldt valves implanted from 11/03 to 8/05 was performed. Data collected pre-operatively, immediately post-operatively, and at 6 months post-operatively included: age at surgery, intraocular pressures, visual acuities, medications, complications, and further surgeries needed. Success was defined as an IOP between 5 mmHg and 22mmHg with or without medications, no further glaucoma surgery required, no visually threatening complications, and light perception maintained. Significance was measured with a paired t-test, with p<.05 being significant.
37 Baerveldt implants were placed in 34 patients. The median age was 48 months, with a range of 4-153 months. Primary glaucoma affected 16 eyes, with the remainder secondary glaucomas. The average preoperative IOP was 35.1mmHg +/-8.3. The six months post-operative IOP was 16.7 mmHg +/-4.6. The mean reduction of IOP postoperatively was 52%. This was significant at p < 0.001. On average before surgery patients used 2.6 medications (range 0-5) before surgery. Post operatively at six months, patients used 1.1 medications (range 0-4). Success as defined previously was met in 32 of 37 eyes (86%), with failures seen in five eyes at six months. Three eyes failed due to serious complications, and two failed due to IOP greater than 22mmHg. Hypotony was a common denominator in the three serious complications, and two of these patients suffered retinal detachments.
Single-stage Baerveldt valve surgery is safe and effective in treating pediatric glaucoma. Our success rate of 86% is comparable to other recent studies evaluating double stage Baerveldt valve surgery in a pediatric population.
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