Baerveldt Aqueous Shunt with or without Mitomycin C Augmentation: A Retrospective Comparison Study

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Adjuncts

Background:

• Baerveldt aqueous shunts are used to manage glaucoma.
• Intraoperative mitomycin C (MMC) is a potential adjunct to enhance surgical success.
• The efficacy of MMC in Baerveldt shunt surgery requires further evaluation.

Purpose of the Study:

• To determine if intraoperative mitomycin C (MMC) impacts the success of Baerveldt aqueous shunts.
• To compare outcomes between patients receiving MMC and a control group.

Main Methods:

• Retrospective comparative case series of 88 patients undergoing Baerveldt shunts.
• 55 patients received intraoperative MMC (0.2-0.4 mg/mL), 33 did not.
• Primary outcome: intraocular pressure (IOP) control (≤21 mmHg or ≤18 mmHg) with or without medications.

Main Results:

• Complete success (medication-free IOP control) was significantly higher with MMC at 5 years (39.3% vs 17.8% for ≤21 mmHg; 38% vs 15.6% for ≤18 mmHg).
• Qualified success (IOP control with medications) showed no significant difference between groups.
• MMC use correlated with fewer glaucoma medications and lower rates of intraluminal ripcord removal (IRR).
• Transient hypotony was more common with MMC, but prolonged hypotony was not significantly different.

Conclusions:

• Intraoperative MMC offers a significant advantage for medication-free Baerveldt shunt success.
• MMC use may reduce the need for glaucoma medications post-surgery.
• While associated with transient hypotony, MMC augmentation appears beneficial for achieving sustained IOP control.