Related Experiment Video

Updated: Jul 16, 2026

Implantation Protocol of the Foldable Capsular Vitreous Body for Complex Vitreoretinal Surgery

Implantation Protocol of the Foldable Capsular Vitreous Body for Complex Vitreoretinal Surgery

Published on: April 14, 2026

Two-Staged versus Single-Staged Baerveldt Implantation in Children with Glaucoma

Brenda L Bohnsack¹, Adam Jacobson²

¹Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Ophthalmology. Glaucoma

|July 14, 2026

Insights

Two-staged Baerveldt implantation in children with glaucoma achieved similar success and survival rates as single-staged procedures, with improved vision stability and reduced medication needs.

Area of Science:

Ophthalmology
Glaucoma Surgery
Pediatric Ophthalmology

Background:

Glaucoma in children requires effective intraocular pressure (IOP) management.
Baerveldt glaucoma drainage devices (GDDs) are utilized for pediatric glaucoma.
Surgical techniques, including staged vs. single-stage implantation, are continuously evaluated.

Purpose of the Study:

To compare the efficacy and safety of two-staged versus single-staged Baerveldt GDD implantation in pediatric glaucoma patients.
To assess outcomes such as IOP control, visual acuity, and need for glaucoma medications.

Main Methods:

Retrospective observational case series comparing children (<18 years) undergoing two-stage Baerveldt implantation (n=25) with age-matched controls receiving single-stage implantation (n=40).
Data collected included demographics, glaucoma type, prior surgeries, best-corrected visual acuity (BCVA), IOP, and glaucoma medications.
Success defined as IOP 5-21 mmHg without additional surgeries or devastating complications; survival curves analyzed.

Main Results:

No significant differences in age, glaucoma type, prior surgeries, follow-up duration, preoperative/final BCVA, IOP, or medication number between groups.
The two-staged group showed significantly fewer instances of vision worsening (p=0.0011).
Both groups demonstrated significant IOP reduction (p<0.0001) and decreased medication use (p<0.05). Success rates were 64% (two-stage) vs. 60% (single-stage), with no difference in survival (p=0.6629).

Conclusions:

Two-staged Baerveldt implantation in children effectively controls IOP with fewer medications compared to single-staged procedures.
Both surgical approaches offer similar success and survival rates for pediatric glaucoma management.
Prior glaucoma surgeries increase the risk of GDD failure.

Read full analysis

Abstract

Purpose:

To compare 2-staged versus single-staged Baerveldt implantation in children with glaucoma.

Design:

Retrospective observational case series.

Subjects:

Children (<18 years of age) who underwent Baerveldt glaucoma drainage device (GDD) placement with at least 6 months of postoperative follow-up.

Methods:

Review of patients with at least 6 months of follow-up who underwent 2-stage Baerveldt placement (n = 25) between 2010 and 2025 and diagnosis and age-matched controls who had 1-stage Baerveldt placement (n = 40). Demographics, ocular diagnoses and surgeries, and examination findings (best-corrected visual acuity [BCVA], intraocular pressure [IOP], and glaucoma medications) were collected.

Main Outcome Measures:

Success and survival of Baerveldt GDD (IOP 5-21 mmHg, no additional IOP-lowering surgeries, and no visually devastating complications), BCVA, IOP, and glaucoma medications.

Results:

Children in the 2-stage Baerveldt and single-stage Baerveldt (control) groups showed no difference in age at surgery, type of glaucoma, prior glaucoma and intraocular surgeries, or length of follow-up. There was also no significant difference in BCVA, IOP, or number of glaucoma medications between the 2 groups before operation or at final follow-up. However, there were fewer patients whose vision worsened between the preoperative and final examinations in the staged group (P = 0.0011). In both groups, final IOP (P < 0.0001) and number of glaucoma medications (P < 0.05) were significantly decreased compared with the preoperative examination. Success at final follow-up was 64% in the 2-stage group and 60% in the controls, and there was no difference in survival curves (P = 0.6629). Greater number of prior glaucoma surgeries was associated with increased risk of failure (odds ratio, 1.7; 95% confidence interval, 1.4-2.2).

Conclusions:

Two-staged Baerveldt placement in children obtained IOP control on fewer medications and showed similar success and survival rates to children who underwent single-staged Baerveldt surgery.

Financial Disclosure(S):

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords:

Baerveldt Glaucoma drainage device Pediatric glaucoma Primary congenital glaucoma

Related Concept Videos

Angle Closure Glaucoma: Treatment

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...

Glaucoma: Overview

Glaucoma: Overview

Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...

Open Angle Glaucoma: Treatment

Open Angle Glaucoma: Treatment

In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...

Articles linked to this work by shared authors, journal, and citation graph.

Successful outcomes of pediatric dacryocystorhinostomy with adjunctive 5-fluorouracil.

Frontiers in ophthalmology·2026

Symani-Assisted Microsurgery in Head and Neck Reconstruction: A Systematic Review of Indications, Techniques, and Pooled Analysis of Clinical Outcomes.

Microsurgery·2026

Equivalent effectiveness of a prescription binocular treatment for amblyopia in real-world practice.

Journal of managed care & specialty pharmacy·2026

Evaluating gene-disease relationship strength in crystallin genes in association with pediatric cataracts.

Ophthalmic genetics·2026

Hybrid Reconstruction in Head and Neck Surgery: Integration of Virtual Planning, Navigation, and Robotic Microsurgery.

Journal of clinical medicine·2026

A Case of Aymé-Gripp Syndromic Congenital Cataracts and Pigmentary Retinopathy Caused by a Novel MAF Variant in the N-Terminal Transactivation Domain-A Case Report and Literature Review.

Genes·2026

See all related articles