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S. Kim, W. E. Smiddy, W. J. Feuer, S. Gedde, D. L. Budenz, R. Parrish, P. Palmberg; Combined Pars Plana Vitrectomy and Baerveldt Glaucoma Implant Placement for Refractory Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1253.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate outcome of combined pars plana vitrectomy and Baerveldt glaucoma implant placement (PPVBGI) for refractory glaucoma.
Retrospective review of 97 PPVBGI cases included 46 neovascular glaucoma cases (NVG) and 51 cases of other indications (Non-NVG).
Cummulative success to maintain light perception of vision and normal range of intraocular pressure(6 to 21mmHg) of Non-NVG vs NVG were 79.1% vs. 49.3% at 1 year, and 79.1% vs. 39.4% at 2 year (p<0.001). No difference was found between pars plana and anterior chamber placement of BGI (p=0.14). Mean preoperative intraocular pressure was 35 mm Hg and the median number of preoperative antiglaucoma medications was two. At 1 year postoperatively, mean intraocular pressure was 13 mm Hg and the median number of antiglaucoma medications was zero. Sixty patients (61.8%) achieved an intraocular pressure greater than 5 mm Hg and less than or equal to 21 mmHg with or without antiglaucoma medications, and 25 patients (25.7%) showed vision improvement better than 2 lines postoperatively. Unclearing vitreous hemorrhage (17 eyes, 17.5%) was most common postoperative complication, and postoperative suprachoroidal hemorrhage secondary to ocular hypotony occurred in 4 eyes (4.1%).
PPVBGI showed promising long-term outcomes in refractory glaucoma regardless of its placement of tube. Outcome may be limited because of severe underlying ocular disease and postoperative complications relating with neovascular glaucoma.
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