Abstract
Abstract: :
Purpose: To evaluate the outcome of combined placement of a scleral buckle and Baerveldt glaucoma implant in patients with coexisting retinal detachment and glaucoma. Methods: The medical records of all patients undergoing simultaneous placement of a scleral buckle and Baerveldt glaucoma implant between January 1997 and September 2003 were reviewed. Preoperative, surgical, and postoperative characteristics were analyzed. Results: Nineteen patients (14 men and 5 women) with a mean age of 58 ± 21 years were included. Mean follow–up was 16 ± 14 months. Mean LogMAR visual acuity improved from 2.13 preoperatively to 1.76 at the most recent follow–up visit. Patients were divided into 3 subgroups depending on the timing of tube insertion: 1) plate placement and tube insertion at the same time of scleral buckling (7 patients); 2) plate placement at the time of scleral buckling with subsequent tube insertion as a secondary procedure (3 patients); 3) plate placement only at the time of scleral buckling (9 patients). At most recent follow–up visit, successful glaucoma control (5 mm Hg ≤ Intraocular Pressure ≤ 22 mm Hg) was noted in 5 patients (71%) from group 1, 2 patients (67%) from group 2, and 7 patients (78%) from group 3. Successful retinal reattachment was achieved in 16 patients (84.2%). Complications included phthisis (1 patient), chronic hypotony (1 patient), corneal graft failure (1 patient). Ocular motility dysfunction, conjunctival wound dehiscence, and implant exposure were not noted in any of the patients. Conclusions: Simultaneous placement of a scleral buckle and Baerveldt glaucoma implant is effective in the management of patients with glaucoma associated with retinal detachment. This approach offers multiple potential advantages over divided procedures including ease of glaucoma implant placement, fewer and less complicated subsequent surgeries, and enhanced flexibility in the timing of tube placement.
Keywords: intraocular pressure • retinal detachment