TY - JOUR
T1 - Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma
AU - Budenz, Donald L.
AU - Scott, Ingrid U.
AU - Nguyen, Quang H.
AU - Feuer, William
AU - Singh, Kuldev
AU - Nicolela, Marcelo T.
AU - Bueche, Michael
AU - Palmberg, Paul F.
PY - 2002/10
Y1 - 2002/10
N2 - Purpose: To describe the surgical technique and clinical outcomes of a procedure for refractory glaucoma, concurrent Baerveldt glaucoma implant (BGI) and trabeculectomy with mitomycin C. Materials and Methods: Medical records of all patients who underwent combined Prolene-ligated BGI and trabeculectomy with mitomycin C were retrospectively reviewed. Main outcome measures were intraocular pressure (IOP), number of glaucoma medications, visual acuity, and complications. Kaplan-Meier survival analysis was used to determine success, defined as IOP < 22 mm Hg, no reoperation for glaucoma, and no loss of light perception vision. Results: The mean ± SD follow-up period for 38 eyes of 36 patients was 34 ± 36 months (range, 3-121 months), during which 18 of 38 eyes (47%) required laser suture lysis of the Prolene suture. Intraocular pressure was reduced from a mean (± SD) preoperative value of 35.7 ± 12.8 to 12.7 ± 4.7 mm Hg at 1-year follow-up and 11.9 ± 5.5 mm Hg at the last follow-up visit (P < 0.001). Number of medicines used for glaucoma was reduced from a mean ± SD preoperative value of 2.5 ± 0.9 to 0.5 ± 0.6 at 1-year follow-up and 0.6 ± 0.8 at the last follow-up visit (P < 0.001). LogMar visual acuity remained stable at mean of 1.15 ± 0.85 preoperatively, compared with 1.14 ± 1.05 at 1-year follow-up, but declined to 1.61 ± 1.01 at the last follow-up visit, a loss of an average of four lines of vision (P = 0.004). Cumulative success was 91% at year 1, 86% at year 2, and 81% at year 3. Three eyes (8%) had suprachoroidal hemorrhages, one eye (3%) needed reoperation for an extruded implant, one (3%) eye had poor vision due to chronic hypotony, three eyes (8%) required additional glaucoma surgery during the postoperative period, and one eye (3%) needed revision of the implant for pressure control. Conclusions: Combined BGI and mitomycin C trabeculectomy provides excellent postoperative IOP control in patients with refractory glaucoma.
AB - Purpose: To describe the surgical technique and clinical outcomes of a procedure for refractory glaucoma, concurrent Baerveldt glaucoma implant (BGI) and trabeculectomy with mitomycin C. Materials and Methods: Medical records of all patients who underwent combined Prolene-ligated BGI and trabeculectomy with mitomycin C were retrospectively reviewed. Main outcome measures were intraocular pressure (IOP), number of glaucoma medications, visual acuity, and complications. Kaplan-Meier survival analysis was used to determine success, defined as IOP < 22 mm Hg, no reoperation for glaucoma, and no loss of light perception vision. Results: The mean ± SD follow-up period for 38 eyes of 36 patients was 34 ± 36 months (range, 3-121 months), during which 18 of 38 eyes (47%) required laser suture lysis of the Prolene suture. Intraocular pressure was reduced from a mean (± SD) preoperative value of 35.7 ± 12.8 to 12.7 ± 4.7 mm Hg at 1-year follow-up and 11.9 ± 5.5 mm Hg at the last follow-up visit (P < 0.001). Number of medicines used for glaucoma was reduced from a mean ± SD preoperative value of 2.5 ± 0.9 to 0.5 ± 0.6 at 1-year follow-up and 0.6 ± 0.8 at the last follow-up visit (P < 0.001). LogMar visual acuity remained stable at mean of 1.15 ± 0.85 preoperatively, compared with 1.14 ± 1.05 at 1-year follow-up, but declined to 1.61 ± 1.01 at the last follow-up visit, a loss of an average of four lines of vision (P = 0.004). Cumulative success was 91% at year 1, 86% at year 2, and 81% at year 3. Three eyes (8%) had suprachoroidal hemorrhages, one eye (3%) needed reoperation for an extruded implant, one (3%) eye had poor vision due to chronic hypotony, three eyes (8%) required additional glaucoma surgery during the postoperative period, and one eye (3%) needed revision of the implant for pressure control. Conclusions: Combined BGI and mitomycin C trabeculectomy provides excellent postoperative IOP control in patients with refractory glaucoma.
KW - Baerveldt drainage implant
KW - Glaucoma drainage implant
KW - Glaucoma surgery
KW - Mitomycin C
KW - Trabeculectomy
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U2 - 10.1097/00061198-200210000-00013
DO - 10.1097/00061198-200210000-00013
M3 - Article
C2 - 12362086
AN - SCOPUS:0036788680
VL - 11
SP - 439
EP - 445
JO - Journal of Glaucoma
JF - Journal of Glaucoma
SN - 1057-0829
IS - 5
ER -