Abstract
ABSTRACTAimTo compare the intermediate-term efficacy of a large surface area Baerveldt 350 mm2 glaucoma drainage device (GDD) with medium surface area implants (Baerveldt 250 mm2 and Molteno 3, 230, or 245 mm2).DesignThis is a retrospective, nonrandomized comparative trial.Materials and methodsA total of 94 eyes of 94 patients of mixed glaucoma diagnoses without any prior glaucoma surgical procedures and who had undergone a glaucoma drainage implant surgery with either a large Baerveldt 350 mm2 GDD or a medium-sized GDD (Baerveldt 250 mm2 or Molteno 230 or 245 mm2) were reviewed for intraocular pressure (IOP), number of glaucoma medications, and visual acuity (VA) preoperatively, and at 1, 2, and 3 years postprocedure.ResultsNo significant differences were found in mean IOP, number of glaucoma medications used, and VA at 1, 2, and 3 years postoperatively. The rate of additional glaucoma procedures was similar between the two groups.ConclusionThere is no clear evidence that a larger implant surface area beyond 230 to 250 mm2 is advantageous in providing intermediate-term IOP control.Clinical significanceIt may be technically easier to surgically place a GDD that does not need to have its wings placed underneath the recti muscles, and the IOP results are similar.How to cite this articleMeyer AM, Rodgers CD, Zou B, Rosenberg NC, Webel AD, Sherwood MB. Retrospective Comparison of Intermediate-term Efficacy of 350 mm2 Glaucoma Drainage Implants and Medium-sized 230-250 mm2 Implants. J Curr Glaucoma Pract 2017;11(1):8-15.
Highlights
For many decades, the primary surgery for lowering intraocular pressure (IOP) in patients with glaucoma has been trabeculectomy
There is no clear evidence that a larger implant surface area beyond 230 to 250 mm[2] is advantageous in providing intermediate-term IOP control
Based on the demographic data collected, there were no significant differences in age, gender, ethnicity, glaucoma diagnosis, study eye, and lens status between the patients who had received a medium plate size implant or a large plate size implant (Table 1)
Summary
The primary surgery for lowering intraocular pressure (IOP) in patients with glaucoma has been trabeculectomy. Like the Schocket and Molteno double-plate implant, often utilized more than one quadrant for creating a bleb over an episcleral plate, and a prospective randomized study by Heuer et al[5] showed better IOP control at 1 and 2 years with a double-plate Molteno than a single-plate Molteno. This led to the concept that a larger surface area may be important in achieving better IOP control with drainage implants. There are different-sized implants, but it is unclear whether the assumption that bigger implants provide better IOP long-term is correct
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