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Outcomes of Baerveldt implantation for pediatric glaucoma following surgery: a systematic review and meta-analysis
Yousef Mesaed Al-Shammari1, Shaikhah Mesaed Al-Shammari2, Basel Bader Alkharraz3
1Department of Ophthalmology, Albahar Eye Center, Ibn Sina Hospital, Kuwait City, Kuwait. Yousef.alnabahan@gmail.com.
Insights
The Baerveldt glaucoma implant (BGI) effectively controls intraocular pressure in pediatric glaucoma after surgery. While generally safe, further long-term studies are needed to confirm its efficacy and safety profile.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Glaucoma Management
Background:
- Pediatric glaucoma following surgery (GFS) is a significant cause of vision loss.
- Glaucoma drainage devices are common, but evidence for the Baerveldt glaucoma implant (BGI) in children is limited.
- Systematic evaluation of BGI efficacy and safety in pediatric GFS is needed.
Purpose of the Study:
- To systematically evaluate the efficacy and safety of the Baerveldt glaucoma implant (BGI) in pediatric patients with glaucoma following surgery (GFS).
Main Methods:
- A systematic review and meta-analysis following PRISMA guidelines.
- Searched five databases up to August 2025 for pediatric cohorts (≤18 years) undergoing BGI post-surgery.
- Pooled intraocular pressure (IOP) outcomes and surgical success rates using random-effects meta-analysis.
Main Results:
- Five studies (116 patients) were included, with average follow-up of 31 months.
- Pooled success rate for IOP control was 84.5% with no heterogeneity.
- Complication rates included hypotony (7.5%), choroidal effusion (9%), phthisis bulbi (2%), endophthalmitis (1.4%), and corneal decompensation (3.3%).
Conclusions:
- BGI offers effective and relatively safe IOP control for pediatric GFS, with complication rates comparable to alternatives.
- Current evidence is limited by small sample sizes, retrospective designs, and short-to-mid-term follow-up.
- Long-term, multicenter prospective studies are required to fully establish BGI's safety and efficacy in this population.
Background:
Pediatric glaucoma following surgery (GFS) remains a serious postoperative complication with potential for vision loss. Although glaucoma drainage devices are widely used in this setting, high-quality pooled evidence on the Baerveldt glaucoma implant (BGI) in children is limited. To systematically evaluate the efficacy and safety of BGI in pediatric patients with GFS.
Methods:
Following PRISMA guidelines, five databases were searched up to August 2025. Eligible studies included pediatric cohorts (≤ 18 years) undergoing BGI after surgery, reporting intraocular pressure (IOP) outcomes or surgical success. Data were pooled using random-effects meta-analysis.
Results:
Five studies (116 patients) met inclusion criteria. The mean age ranged from 3.0-7.8 years, with average follow-up of 31 months. The pooled success rate of IOP control was 84.5% (95% CI 0.75-0.91), with no evidence of heterogeneity. Hypotony occurred in 7.5%, choroidal effusion in 9%, and rare events included phthisis bulbi (2%), endophthalmitis (1.4%), and corneal decompensation (3.3%).
Conclusion:
BGI provides effective and relatively safe IOP control after surgery, with complication rates comparable to or lower than alternative surgical options. However, the current evidence is limited by small sample sizes, retrospective study designs, and short- to mid-term follow-up. Long-term, multicenter prospective studies are needed to better define its long-term safety and efficacy.
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