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M. J. Pokabla, J. S. Schuman, M. Herceg, M. B. Pantcheva, R. J. Noecker, III, L. Camejo; The Placement of Baerveldt Glaucoma Drainage Device Without the Use of Plate-To-Sclera Stabilizing Sutures. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4454.
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To evaluate the safety and efficacy of Baerveldt glaucoma drainage device placement without the use of plate-to-sclera stabilizing sutures.
Seventy-six consecutive Baerveldt glaucoma drainage devices (BGDD) were placed by a single surgeon, utilizing a standardized technique without the use of plate-to-sclera stabilizing sutures. A single suture was used to secure the tube to the sclera 1mm posterior to the sclerotomy to minimize tube and/or plate migration.
The mean age of sample size (n=76) was 64.8 (± SD 17.2). Mean preoperative intraocular pressure (IOP) was 25.2 mmHg (± SD 8.5). The mean preoperative number of drops was 2.5 (± SD 1.2). Post-operative day 1 mean IOP was 14.5 mmHg (± SD 11.2). Last follow-up visit mean IOP was measured at 13.9 mmHg (± SD 6.2) (mean number of days at last follow-up visit = 161, ± SD 118.6). The mean number of drops used at the last day follow-up visit was 0.91 (± SD 0.99). Noted complications included hypotony, bleb leak, choroidal detachment, and transient hyphema. Migration of the tube and or plate occurred in 1.3% of patients. Revision of the BGDD for all indications occurred in 5.3% of all patients. Diplopia occurred in 2.6% of all patients.
Minimization of suture use when placing a BGDD may prevent unnecessary complications such as perforation and device malpositioning. It may also limit costs of surgery, reduce time spent in the operating room, and possibly lead to a better-positioned device. When devices are well positioned during surgery in settings free of adhesions and other anatomical restrictions, it does not appear that the plates of these devices migrate significantly.The absence of plate-to-sclera sutures in BGDD placement has been found to be a safe and effective alternative technique that provides similar IOP control and safety profiles to other techniques in which the plate is sutured.
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