Baerveldt 250 mm2 Glaucoma Drainage Devices in Eyes With Preexisting Scleral Buckles.

ABSTRACT

PURPOSE: To evaluate eyes with preexisting scleral buckles (SBs) that underwent placement of a 250 mm Baerveldt glaucoma drainage device (GDD). PATIENTS AND METHODS: Records of all patients with a preexisting SB who underwent 250 mm Baerveldt GDD placement at the Kellogg Eye Center between January 1, 2005 and September 30, 2012 were reviewed. Outcome measures included visual acuity (VA), intraocular pressure (IOP), and number of glaucoma medications prescribed. RESULTS: Seventeen eyes of 17 patients were analyzed. Mean follow-up was 23.9 months. Twelve eyes (70.6%) achieved successful control of IOP (<22 mm Hg, not requiring additional IOP reduction procedures, and no devastating complications). Preoperatively, mean IOP was 25.5 mm Hg, mean number of glaucoma medications was 3.5, and mean logMAR VA was 1.1 (Snellen equivalent 20/200). At 1 and 2 years postoperatively, mean IOP was 9.2 and 8.8 mm Hg (P<0.001), and mean number of glaucoma medications was 0.9 and 0.3 (P<0.001), respectively. There were no statistically significant changes in logMAR VA at 1 and 2 years postoperatively (P=0.45 and 0.99, respectively). Complications included conjunctival dehiscence (4 eyes, 24%), wound leak (2 eyes, 12%), tube and plate exposure requiring removal of drainage device (2 eyes, 12%), phthisis (2 eyes, 12%), and hemorrhagic choroidal detachment (1 eye, 6%). CONCLUSIONS: In eyes with preexisting SBs, the Baerveldt 250 mm GDD effectively lowers IOP and reduces the number of glaucoma medications. Complications related to conjunctival dehiscence are not uncommon in these eyes with significantly scarred conjunctiva.