May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Combined Pars Plana Vitrectomy and Baerveldt Glaucoma Implant Placement for Refractory Glaucoma
Author Affiliations & Notes
  • S. Kim
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
    Ophthalmology, Yonsei Univ Yongdong Severance Hosp, Seoul, Republic of Korea
  • W. E. Smiddy
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • W. J. Feuer
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • S. Gedde
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • D. L. Budenz
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • R. Parrish
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • P. Palmberg
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • Footnotes
    Commercial Relationships  S. Kim, None; W.E. Smiddy, None; W.J. Feuer, None; S. Gedde, None; D.L. Budenz, None; R. Parrish, None; P. Palmberg, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 1253. doi:https://doi.org/
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    • Get Citation

      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. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate outcome of combined pars plana vitrectomy and Baerveldt glaucoma implant placement (PPVBGI) for refractory glaucoma.

Methods: : Retrospective review of 97 PPVBGI cases included 46 neovascular glaucoma cases (NVG) and 51 cases of other indications (Non-NVG).

Results: : 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%).

Conclusions: : 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.

Keywords: vitreoretinal surgery • neovascularization • diabetic retinopathy 
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