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Akira Sugano, Koichi Nishitsuka, Hidetoshi Yamashita; Primary Baerveldt glaucoma implant surgery for neovascular glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2074. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate outcomes and factors associated with primary Baerveldt glaucoma implant (BGI) surgery for neovascular glaucoma (NVG).
The medical records of 22 patients (14 males and 8 females; 27 eyes) with NVG who underwent primary BGI surgery for NVG at the Yamagata University Hospital between 2013 and 2016 were included in the study. All patients with NVG were treated with panretinal photocoagulation and pars plana vitrectomy (PPV) before BGI surgery. Outcomes were assessed by measures of intraocular pressure (IOP), visual acuity, postoperative complications, and the cumulative success rate. Success was achieved in cases with visual acuity better than hand motions, IOP between 6 and 21 mmHg , and no subsequent glaucoma surgery. Finally, we evaluated the final IOP in the subgroup analyses (based on etiologies of NVG, stage of NVG, and subsequent PPV).
The mean patient age was 54 years, and the mean follow up time was 21.8 months. The etiologies of NVG were proliferative diabetic retinopathy (18 eyes), Ocular ischemic syndrome (6 eyes), and branch retinal vein occlusion (3 eyes). The preoperative mean IOP was 41.4 mmHg. The postoperative mean IOP at 1-, 6-, 12-, 24-, and 36-month follow-ups was 15.3 mmHg, 14.7 mmHg, 14.0 mmHg, 14.6 mmHg, and 16.8 mmHg, respectively. The final mean logMAR visual acuity was slightly worse compared with the preoperative mean measure, but there was no significant difference. The most common postoperative complications were vitreous hemorrhage [n = 6 (22%)] and anterior proliferative vitreoretinopathy [n = 1 (4%)]. The cumulative success rates at 2 and 3 years were 86.4% and 71.8%, respectively, and the final IOP was not significantly different in the subgroup analyses.
Primary BGI surgery was a useful procedure for all types of NVGs.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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