Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma

Donald L. Budenz, Ingrid U. Scott, Quang H. Nguyen, William J Feuer, Kuldev Singh, Marcelo T. Nicolela, Michael Bueche, Paul Palmberg

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)439-445
Number of pages7
JournalJournal of Glaucoma
Volume11
Issue number5
StatePublished - Oct 1 2002

Fingerprint

Glaucoma Drainage Implants
Trabeculectomy
Mitomycin
Glaucoma
Intraocular Pressure
Polypropylenes
Reoperation
Sutures
Visual Acuity
Eye Hemorrhage
Kaplan-Meier Estimate
Survival Analysis
Postoperative Period
Medical Records
Lasers

Keywords

  • Baerveldt drainage implant
  • Glaucoma drainage implant
  • Glaucoma surgery
  • Mitomycin C
  • Trabeculectomy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Budenz, D. L., Scott, I. U., Nguyen, Q. H., Feuer, W. J., Singh, K., Nicolela, M. T., ... Palmberg, P. (2002). Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma. Journal of Glaucoma, 11(5), 439-445.

Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma. / Budenz, Donald L.; Scott, Ingrid U.; Nguyen, Quang H.; Feuer, William J; Singh, Kuldev; Nicolela, Marcelo T.; Bueche, Michael; Palmberg, Paul.

In: Journal of Glaucoma, Vol. 11, No. 5, 01.10.2002, p. 439-445.

Research output: Contribution to journalArticle

Budenz, DL, Scott, IU, Nguyen, QH, Feuer, WJ, Singh, K, Nicolela, MT, Bueche, M & Palmberg, P 2002, 'Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma', Journal of Glaucoma, vol. 11, no. 5, pp. 439-445.
Budenz DL, Scott IU, Nguyen QH, Feuer WJ, Singh K, Nicolela MT et al. Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma. Journal of Glaucoma. 2002 Oct 1;11(5):439-445.
Budenz, Donald L. ; Scott, Ingrid U. ; Nguyen, Quang H. ; Feuer, William J ; Singh, Kuldev ; Nicolela, Marcelo T. ; Bueche, Michael ; Palmberg, Paul. / Combined Baerveldt glaucoma drainage implant and trabeculectomy with mitomycin C for refractory glaucoma. In: Journal of Glaucoma. 2002 ; Vol. 11, No. 5. pp. 439-445.
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AU - Budenz, Donald L.

AU - Scott, Ingrid U.

AU - Nguyen, Quang H.

AU - Feuer, William J

AU - Singh, Kuldev

AU - Nicolela, Marcelo T.

AU - Bueche, Michael

AU - Palmberg, Paul

PY - 2002/10/1

Y1 - 2002/10/1

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.

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KW - Baerveldt drainage implant

KW - Glaucoma drainage implant

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KW - Mitomycin C

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