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Mirela Krasniqi, Deepak P Edward, Jeffrey Dunmire, Evan Lagouros, Rachida Bouhenni, Matthew Willett, Todd Woodruff; Long-term outcomes of Baerveldt glaucoma implant (BGI) shunts. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3190.
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To report on long-term intraocular pressure (IOP) outcomes of the BGI as a primary or secondary procedure in different types of glaucoma.
Retrospective, non-comparative case series of BGI (350mm2 in 89.2%) by a single surgeon for various types of glaucoma. Success was defined as IOP < 21mmHg with/without medications, lack of visual field progression or need for additional glaucoma surgery. Success rates were calculated for the overall group and those undergoing primary BGI’s.
In n=203 (n=154 primary; n=49 secondary; follow up range of 2-12 years with mean follow up time of 5.8±2.31 years; POAG most common in 55.7% patients), mean IOP was reduced from 30.6±10.22 mmHg preoperatively to 5, 7, and 9-year mean postoperative values of 13.1±5.00 mmHg (57.0% reduction, P <0.001), 13.5±5.55 mmHg (55.9% reduction, P <0.001), and 12.9±5.0 mmHg (57.8% reduction, P <0.001) respectively. The mean medications were reduced from 3.0±1.06 preoperatively to 1.2±1.11, 1.4 ±1.10, and 1.7±1.07 at 5, 7, and 9 years respectively. The overall success rates at 5, 7, and 9- year follow-up times were 83.5% (91/109), 81.5% (44/54), 66.7% (18/27) respectively. BGI as a primary procedure was performed in n=154 (75.9%) with a follow-up dropout to n=77 at 5 years, n=36 at 7 years, and n=18 at 9 years. The success rates for the primary BGI were 85.7%, 83.3%, and 72.2% respectively at 5, 7, and 9-year follow up. Significant risk factors in the overall group for failure at 9 years included age <56.7 years at surgery (p<0.001) and female gender (p=0.046).
This study demonstrates moderate long term success rates for BGI performed as a primary procedure and as an overall group. There was an overall significant, persistent long term IOP reduction at 5, 7, and 9 years. A decrease in glaucoma medication use was noted long-term in the overall study group. The study shows that BGI’s as a primary or secondary procedure are an effective treatment for long-term intraocular pressure control in glaucoma patients.
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