A ten-year study of Baerveldt glaucoma drainage device in an Australian paediatric population

Childhood glaucoma is a rare condition that presents a significant management challenge often requiring surgical intervention. This study evaluates the epidemiology, efficacy and safety profile of Baerveldt glaucoma drainage devices (GDDs) in an Australian paediatric population over ten years.

A retrospective review of all patients under 18 years who underwent anterior chamber Baerveldt 101-350 implantation between January 2014 and January 2024 in an Australian tertiary referral centre was conducted. Patient characteristics, ocular examination and surgical details were collected. Survival rates were estimated using Kaplan-Meier analysis.

Eighty-one Baerveldt GDDs were inserted in 80 eyes of 63 children at median 4.0 years. Prior glaucoma surgery was documented in 48.1% of cases. The most common indication was refractory glaucoma following cataract surgery (38.8%). A significant reduction in intraocular pressure (IOP) and medication requirement was observed at final follow-up (p < 0.001), with 36.3% of eyes requiring no glaucoma medications. The one-, five- and ten-year survival rates were 90.1%, 71.1% and 62.9% respectively. Twenty GDDs failed, predominantly due to elevated IOP. Complications occurred in 12.3% of cases with the most common being hypotony (4.9%) followed by tube retraction (3.7%).

Baerveldt 101-350 GDDs can provide effective long-term IOP control with a favourable safety profile. We noted a higher proportion of patients with glaucoma following cataract surgery in comparison to previous studies. Outcomes of this large single surgeon series compare favourably with existing literature and support the use of Baerveldt GDDs as a reliable option in childhood glaucoma refractory to other approaches.