Fibrotic response after Baerveldt glaucoma drainage device surgery: an initial sight-threatening sign in eyes with...

We report the pathological analysis of a postoperative fibrotic reaction as an initial sign of a sight-threatening complication observed during the 2-year outcomes follow up of Baerveldt glaucoma implant (BGI) surgery in eyes with refractory childhood glaucoma.

Retrospective case series.

Fifteen eyes of 10 patients with refractory childhood glaucoma underwent BGI surgery between 2013 and 2020 at the University of Osaka Hospital. Patients were followed for a minimum of 2 years postoperatively. We investigated the postoperative complications, and histopathologically analyzed the specimens obtained from three eyes with postoperative fibrous membranes on the irises.

Nine eyes (60%) had a postoperative fibrous membrane around the tube or on the iris close to the tube, whereas two eyes developed a tractional retinal detachment. The pathological results indicated the tissues were eosinophilic fibrous scar tissues that did not have inflammatory or neoplastic lesions.

BGI surgery was effective in patients with refractory childhood glaucoma. However, clinicians should be alert to the potential for development of fibrotic ocular inflammation in refractory childhood glaucoma eyes.