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Clinical Outcomes and Risk Factors for Surgical Failure Following Baerveldt Glaucoma Implant Surgery as a Primary
Kentaro Iwasaki1, Ayami Katsuo1, Shogo Arimura1
1Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.
Journal of Clinical Medicine
|June 26, 2026
Summary
Baerveldt glaucoma implant (BGI) surgery effectively lowers intraocular pressure (IOP) long-term in patients without prior glaucoma surgery. Younger patients face a higher risk of surgical failure, highlighting the need for personalized treatment strategies.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Device Technology
Background:
- Evaluating Baerveldt glaucoma implant (BGI) surgery as a primary intervention for glaucoma.
- Assessing clinical outcomes and prognostic factors in eyes without previous glaucoma filtering surgery.
Purpose of the Study:
- To determine the efficacy and safety of BGI surgery as an initial surgical treatment for glaucoma.
- To identify factors influencing the success rate of primary BGI implantation.
Main Methods:
- Retrospective cohort study of 148 eyes undergoing BGI surgery with a 350-mm² endplate.
- Surgical success defined by intraocular pressure (IOP) thresholds, IOP reduction, need for further surgery, or vision loss.
- Kaplan-Meier survival analysis and Cox regression used for outcome and prognostic factor evaluation.
Main Results:
- Five-year success rates were 70.6% (IOP ≤ 21 mmHg), 49.8% (IOP ≤ 17 mmHg), and 27.6% (IOP ≤ 14 mmHg).
- Mean IOP significantly decreased from 33.5 mmHg to 13.9 mmHg, and medication use reduced from 4.0 to 1.8.
- Younger age and prior intraocular surgeries were associated with increased risk of surgical failure.
Conclusions:
- Primary BGI surgery provides favorable long-term IOP control in treatment-naïve glaucoma patients.
- Younger patient age is a significant prognostic factor for poorer surgical outcomes.
- Complications occurred in 34.5% early and 14.2% late postoperatively, with 20.9% requiring interventions.
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