Purpose: To determine the intermediate-term efficacy and safety of Baerveldt glaucoma implants in Asian eyes with complicated glaucoma.
Design: Retrospective, nonrandomized, comparative trial.
Participants: One hundred twenty-four Asian patients (124 eyes) with complicated glaucoma.
Intervention: Implantation of 54 250-mm(2) and 70 350-mm(2) Baerveldt glaucoma drainage implants at Singapore National Eye Center from 1994 through 1999.
Main outcome measures: Intraocular pressure, number of glaucoma medications, and complications.
Results: The mean follow-up period was 33.4 +/- 14.4 months (mean +/- SD; range, 12-72 months). Intraocular pressure (IOP) was reduced from a mean preoperative IOP of 36.5 +/- 10.7 mmHg (range, 21-80 mmHg) to 15.3 +/- 6.0 mmHg (range, 1-34 mmHg), and the number of glaucoma medications decreased from 2.6 +/- 0.6 (range, 1-5) before the time of surgery to 0.5 +/- 0.9 (range, 0-4) medications at last follow-up. Overall, there were 67 eyes (54%) that were classified as complete successes, 27 eyes (22%) that were qualified successes, and 30 eyes that failed (24%). Postoperative complications occurred in 43 eyes (34.7%), and 21 eyes (17%) required further surgical intervention and revision. There was no statistically significant difference between the 250-mm(2) and 350-mm(2) type of implants in terms of success rates, final IOP, number of medications, and rates of complications. After adjusting for gender, preoperative IOP, and length of follow-up, increasing age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; P = 0.02) and the number of previous operations performed before implant surgery (OR, 1.57; 95% CI, 1.07-2.31; P = 0.01) were found to be correlated positively with failure.
Conclusions: In Asian eyes with complicated glaucoma, Baerveldt glaucoma implants achieve stable and satisfactory IOP reduction with low incidence of complications in the intermediate term after surgery.