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Initial experience with pneumatically stented baerveldt implant modified for pars plana insertion for complicated
J K Luttrull1, R L Avery, G Baerveldt
1University of California, Santa Barbara, USA.
Objective:
To assess the efficacy of pneumatically stented drainage tube implants specially modified for pars plana insertion in the treatment of complicated glaucoma.
Design:
Retrospective, non-comparative case series.
Participants:
50 consecutive patients with refractory complicated glaucoma nonresponsive to medical treatment.
Intervention:
Baerveldt glaucoma implants modified by Hofmann for pars plana insertion were placed following pars plana vitrectomy and gas-fluid exchange (pneumatically stented implant, or PSI procedure).
Main Outcome Measure:
Reduction of intraocular pressure (IOP) to 21 mmHg or less.
Results:
31 neovascular and 19 complicated non-neovascular glaucoma eyes in 48 patients referred to a vitreoretinal subspecialty practice, average age 69 years (range 29-91), were followed an average of 18 months (range 3-41). The average preoperative IOP was 44 mmHg (14-78) on an average 3.2 glaucoma medications (range 2-6). The average final postoperative IOP was 14 mmHg (range 5-31) on an average 0.6 glaucoma medications (range 0-3, median 0). The final intraocular pressure was 21 mmHg or less in 47 of 50 (94%) operated eyes. Serious complications related to the procedure occurred in five eyes (10%).
Conclusions:
Pneumatically stented Baerveldt glaucoma implants modified with the Hofmann elbow to facilitate pars plana insertion are effective in the treatment of complicated glaucoma.