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AD Cortes, D WuDunn, LB Cantor; Short Term Outcomes of Inferior Versus Superior Placement of Baerveldt Tube Shunts . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3377.
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Purpose: To evaluate the efficacy and safety of inferior placement of Baerveldt tube shunts. Methods: Retrospective review of 20 patients who underwent an inferior Baerveldt tube shunt procedure (Inferior group) from 1996-2001 at Indiana University and comparison with 39 control subjects who underwent superior tube shunt placement (Superior group) during the same time interval. Intraocular pressure (IOP), antiglaucoma medications, visual acuity and complications were noted. Success was defined as intraocular pressure less than 21 with or without medications. Results: The mean age SD was 63.5 18.5 years in the Superior group and 62.2 18.2 years in the Inferior group (P=0.79). Mean preoperative IOP for the Superior and Inferior tube groups were 35.1 15.9 mmHg and 37.2 8.9 (P=0.59), respectively. Mean number of prior intraocular procedures were 1.5 1.1 for the Superior group and 2.9 0.8 for the Inferior group (P<0.001). The superior group included more cases of neovascular glaucoma (11/39 vs. 1/20, P=0.04). Final mean IOP was 19.8 8.8 mmHg for the Superior group and 15.9 7.6 mmHg for Inferior group (P=0.10). Kaplan-Meier cumulative survival was 0.69 in the Superior group and 0.88 in the Inferior group at 6 and 12 months (P=0.14 overall). View OriginalDownload SlideView OriginalDownload Slide Mean follow-up was 7.4 months (range 1-25 months) for the Superior group and 9.6 months (range 1-20 months) for the Inferior group. Hyphema was the most common complications for Superior group (15/39 Superior vs. 1/20 Inferior, P=0.006) whereas strabismus was more common in the Inferior group (1/39 Superior vs. 4/20 Inferior, P=0.04). Conclusion: Inferiorly-placed tube shunts seem to work at least as well as superiorly-placed tube shunts. Except for strabismus, complications were no worse in eyes that had inferior tube implantation.
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