Primary outcomes of Baerveldt glaucoma implants with a modified technique to control intraocular pressure in different cases of glaucoma.

INTRODUCTION: To describe the outcomes of Baerveldt glaucoma implants implanted via a modified technique with regard to early intraocular pressure (IOP) reduction in cases of uncontrolled glaucoma. METHODS: The medical records of patients who had Baerveldt glaucoma implants of 350 or 250 mm2 implanted via a modified technique and were followed up for a period of at least 6 months were reviewed. The primary outcome measures were the mean IOP and number of glaucoma medications at each visit. We evaluated complete success rates at 1 day, 1 week and 1 month, defined as IOP values [Formula: see text] 5 mmHg and ≤ 21 mmHg prior to ligature rupture. RESULTS: A total of 42 eyes had Baerveldt glaucoma implants and met the inclusion criteria. The mean preoperative intraocular pressure (IOP) was 34.2 ± 11.2 mmHg. The postoperative mean IOP values were 15.1 mmHg ± 8.8 (p < 0.05), 17.7 ± 7.1 mmHg (p < 0.05), 12.3 ± 4.0 mm Hg (p < 0.05) at 1 day, 1 month, and 6 months, respectively. The rate of complete success on the first day was 78%, at the first month was 69%, and at 6 months was 95.2%. The number of glaucoma medications used was significantly lower at 6 months (P = < 0.001). CONCLUSION: The modified surgical technique using Baerveldt implants enables a safe, effective, and reliable IOP control in early postoperative patients with uncontrolled glaucomas.

Hemorrhagic Descemet Membrane Detachment during Ab Interno Canaloplasty.

PURPOSE: To describe a Descemet membrane detachment in peripheral cornea after canaloplasty with ab interno approach in glaucoma. CASE REPORT: A 60-year-old male with uncontrolled primary open-angle glaucoma (POAG) underwent ab interno canaloplasty in the left eye. The previous corrected visual acuity was 20/400 and intraocular pressure 26 mmHg with maximum medical therapy. There was evidence of minor intrastromal bleeding and limited Descemet membrane detachment during the introduction of intracanalicular viscoelastic. Speculate that the Descemet detachment occurred owing to the excessive pressure while injecting the viscoelastic. A conservative management was decided due to the size of the detachment outside the visual axis. On the first postsurgical day, the slit lamp biomicroscopy confirmed that the paralimbal extension of the pre-Descemet hemorrhage was 3mm and the radial extension was 2mm. Moreover the initial thickness of the pre-Descemet hemorrhage measurement with anterior segment OCT was 0.6mm. The follow-up was done weekly. At 3 months postoperatively, cornea recovered its transparency and morphology and intraocular pressure was 18mmHg with maximum medical therapy. CONCLUSION: Descemet membrane detachment by viscoelastic with partial intrastromal hematoma is a rare complication of the ab interno canaloplasty, which can be managed conservatively if it has not compromised the visual axis and has a limited extension.