Intermediate-term outcome of Baerveldt glaucoma implants in Asian eyes

Abstract

Purpose To determine the intermediate-term efficacy and safety of Baerveldt glaucoma implants in Asian eyes with complicated glaucoma. Design Retrospective, nonrandomized, comparative trial. Participants One hundred twenty-four Asian patients (124 eyes) with complicated glaucoma. Intervention Implantation of 54 250-mm 2 and 70 350-mm 2 Baerveldt glaucoma drainage implants at Singapore National Eye Center from 1994 through 1999. Main outcome measures Intraocular pressure, number of glaucoma medications, and complications. Results The mean follow-up period was 33.4 ± 14.4 months (mean ± SD; range, 12–72 months). Intraocular pressure (IOP) was reduced from a mean preoperative IOP of 36.5 ± 10.7 mmHg (range, 21–80 mmHg) to 15.3 ± 6.0 mmHg (range, 1–34 mmHg), and the number of glaucoma medications decreased from 2.6 ± 0.6 (range, 1–5) before the time of surgery to 0.5 ± 0.9 (range, 0–4) medications at last follow-up. Overall, there were 67 eyes (54%) that were classified as complete successes, 27 eyes (22%) that were qualified successes, and 30 eyes that failed (24%). Postoperative complications occurred in 43 eyes (34.7%), and 21 eyes (17%) required further surgical intervention and revision. There was no statistically significant difference between the 250-mm 2 and 350-mm 2 type of implants in terms of success rates, final IOP, number of medications, and rates of complications. After adjusting for gender, preoperative IOP, and length of follow-up, increasing age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01–1.09; P = 0.02) and the number of previous operations performed before implant surgery (OR, 1.57; 95% CI, 1.07–2.31; P = 0.01) were found to be correlated positively with failure. Conclusions In Asian eyes with complicated glaucoma, Baerveldt glaucoma implants achieve stable and satisfactory IOP reduction with low incidence of complications in the intermediate term after surgery.