Abstract
Purpose:
To report the short and mid-term results of Baerveldt 350-mm2 implant (Abbott Medical Optics, Inc., Santa Ana, CA) performed by third-year residents and first-year glaucoma fellows for treatment of adult glaucoma.
Methods:
This was a retrospective, noncomparative, interventional case series. Patients aged 18 years or older with uncontrolled glaucoma refractory to maximum medical therapy and submitted to Baerveldt 350-mm2 glaucoma implant were included. Main outcome measures were intraocular pressure (IOP), visual acuity, number of glaucoma medications and surgical complications.
Results:
58 subjects were included (52% were male). Mean age was 56.62+/-14.76 years. From all included subjects, 36% presented primary open angle glaucoma, 33% neovascular glaucoma and 16% glaucoma secondary to ocular surgery. Fifty-three percent of all patients had previously failed trabeculectomy. Median (interquartile range) postoperative follow-up was 9 months (6 to 12 months). Median (interquartile range) preoperative intraocular pressure (IOP) on maximal medical therapy was 27 mmHg (20 to 40 mmHg). Median (interquartile range) postoperative intraocular pressure at final visit was 14 mmHg (11 to 20 mmHg) (P<0.0001,Wilcoxon signed rank test). A significant difference in the number of glaucoma medications was observed before and after glaucoma implant (2.7 ±0.8 vs 1.4 ± 1.2 ,p <0.0001). Complications that required surgical intervention was observed in 27.6% of all included patients (hypotony-related vision-threatening complications accounted for 37.5% of all events).
Conclusions:
The Baerveldt 350-mm2 glaucoma implant surgery provided good short and mid-term results for the treatment of adult refractory glaucoma when performed by supervised residents and fellows in training.
Keywords: 568 intraocular pressure •
420 anterior chamber •
754 visual acuity