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KB Hoffman, RM Feldman, DL Budenz, SJ Gedde, G Abou Chacra, JC Schiffman; Combined Cataract Extraction and Baerveldt Glaucoma Drainage Implant: Indications and Outcomes . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3339.
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Purpose:To report the indications and outcomes of simultaneous cataract extraction (CE)and Baerveldt glaucoma drainage implant (BGI)surgery. Methods:The medical records of all consecutive patients who underwent combined CE and BGI surgery at two tertiary care referral centers were reviewed. Demographic and clinical data for each patient was recorded, and statistical analysis was performed. Clinical data included indication for BGI; preoperative visual acuity, intraocular pressure, and number of glaucoma medications; postoperative visual acuity, intraocular pressure, and number of medications at months 3, 6, 12, 18, and last follow-up; and complications of treatment. Results:The study included 33 eyes of 33 patients followed for an average of 15.4 months (range = 3.0 - 46.9). The most common indication for combined cataract extraction and Baerveldt glaucoma drainage implant surgery was a history of prior failed trabeculectomy. Postoperative visual acuity at last follow-up was ≥ 20/40 in 12/33 patients (36%). IOP was reduced from a mean (± standard deviation) of 21 ± 7.3 mmHg preoperatively to 13.1 ± 3.5 mmHg at last follow-up visit (p<.001). The number of antiglaucoma medications was reduced from a mean (± standard deviation) of 2.3 ± 1.0 preoperatively to 0.7 ± 1.1 at last follow-up (p<.001). Three eyes met our criteria for failure, and cumulative survival of the glaucoma surgery at 18 months was 89%. Intraoperative complications were all related to the cataract surgery; while early and late postoperative complications were related both to the CE and BGI surgery. Conclusion:Combined cataract extraction and Baerveldt glaucoma drainage implant surgery appears to be a safe and effective surgical option and may be preferred in certain clinical situations.
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