Surgical outcomes of Baerveldt implants in pediatric glaucoma patients

Abstract

To evaluate the efficacy of the Baerveldt glaucoma implant (BGI) in children. The medical records of pediatric glaucoma patients aged 5 months to 19 years who underwent BGI placement by a single surgeon (JCS) between January 1, 2000, and March 1, 2010, were retrospectively reviewed. Patients were evaluated at 3-9 months, 12-18 months, and 24-30 months after surgery. We defined surgical success as a postoperative intraocular pressure (IOP) of >6 mm Hg and <21 mm Hg, without additional glaucoma surgery, loss of light perception, removal of the BGI, chronic hypotony, retinal detachment, malignant glaucoma, endophthalmitis, or phthisis bulbi. Additional outcome measures were tube erosion, corneal decompensation, tube retraction, visual acuity, clinical bleb encapsulation, and choroidal detachment. A total of 45 eyes of 36 patients were included. The mean preoperative IOP was 31.6 ± 5.0 mm Hg; the mean postoperative IOP, 16.3 ± 5.1 mm Hg at 3-9 months, 19.5 ± 4.8 mm Hg at 12-18 months, and 18.3 ± 4.8 mm Hg at 24-30 months. Cumulative probability of success was 93.3% at 3-9 months, 86.7% at 12-18 months, and 86.7% at 24-30 months. Overall, 6 eyes failed within 30 months because of uncontrolled IOP (3 eyes), replacement of the glaucoma drainage device (2 eyes), and no light perception (1 eye). In this study cohort, BGI surgery effectively reduced IOP in pediatric patients with refractory glaucoma.