Abstract
Abstract: :
Purpose: To compare the efficacy of intraocular pressure (IOP) control of the Baerveldt-350 implant with tube ligature and the Ahmed valve in refractory glaucoma. Method: 339 tube shunt procedures from 1995 to 2000 were reviewed retrospectively. 17 cases of Baerveldt-350 implantation performed in patients with at least 10 years of age and had glaucoma refractory to medical treatment and glaucoma filtering procedures, without previous tube shunt procedure, and with minimum of 1-year follow-up were identified. 17 cases of Ahmed valve implantation were matched case by case with the 17 Baerveldt-350 cases for glaucoma subtype, preoperative IOP, surgeon, previous ocular surgery, age and race. The two groups were compared for IOP control, visual outcome, complication rate, and surgical success rate. Surgical success rate was defined as IOP reduction of more than or equal to 30% and final IOP more than 5 mm Hg and less than 22 mm Hg, without visually devastating complications. Results: Over a follow-up period of 1 year, no statistically significant difference was detected between the Baerveldt-350 implant vs. Ahmed valve for IOP control (11.8 ± 4.3 mmHg vs. 12.7 ± 4.8 mm Hg respectively, at a power of 90% and p=0.05), surgical success rate (12.5% vs. 17.7% respectively), postoperative hypotony rate (42% vs. 35.2% respectively), and visual acuity changes of more than 1 line in Snellen visual acuity (33.3% vs. 35.3% respectively). Conclusion: In a case-controlled comparison, the Baerveldt-350 implant and the Ahmed valve had similar IOP control and surgical outcomes in patients with refractory glaucoma at 1 year follow-up.
Keywords: 353 clinical (human) or epidemiologic studies: outcomes/complications • 444 intraocular pressure • 498 optic disc