Baerveldt glaucoma implant in the management of refractory childhood glaucomas

Donald L. Budenz, Steven J. Gedde, James D Brandt, David Kira, William Feuer, Eric Larson

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Abstract

Purpose To evaluate the effectiveness and safety of the Baerveldt glaucoma drainage implant (GDI) in the management of pediatric glaucomas. Design Retrospective noncomparative case series. Participants Sixty-two children younger than 18 years who underwent Baerveldt GDI surgery. Main outcome measures Intraocular pressure (IOP), intraoperative and postoperative complications, number of glaucoma medications, and VA. Success was defined as IOP of <22 mmHg and ≥5 mmHg with or without medications, no loss of light perception, and no further surgical intervention for glaucoma. Outcomes were compared for patients with primary and secondary glaucomas. Results Sixty-two eyes of 62 patients were identified. The mean patient age (± standard deviation) at time of Baerveldt glaucoma implant surgery was 6.5±5.6 years (range, 6 weeks-17 years). With an average follow-up of 23.4±21.7 months (range, 1-106), IOP was reduced from a mean of 35.0±8.7 mmHg (range, 17-54) preoperatively to 17.6±8.4 mmHg (range, 5-45) at last follow-up visit (P<0.001). Kaplan-Meier survival analysis showed a cumulative success of 85% at 6 months, 80% at 12 months, 67% at 24 months, and 60% in months 28 through 106. There was no difference between primary (N = 23) and secondary glaucoma (N = 39) patients in terms of length of follow-up, final IOP, number of medications, or cumulative success (P = 0.21). Conclusion Baerveldt glaucoma implant surgery seems to be an effective treatment for primary and secondary refractory glaucomas in children. There is a risk of retinal detachment that may be related to the implant or other ocular conditions.

Original languageEnglish (US)
Pages (from-to)2204-2210
Number of pages7
JournalOphthalmology
Volume111
Issue number12
DOIs
StatePublished - Dec 2004

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Glaucoma Drainage Implants
Glaucoma
Intraocular Pressure
Intraoperative Complications
Kaplan-Meier Estimate
Retinal Detachment
Survival Analysis
Outcome Assessment (Health Care)
Pediatrics
Safety

ASJC Scopus subject areas

  • Ophthalmology

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Baerveldt glaucoma implant in the management of refractory childhood glaucomas. / Budenz, Donald L.; Gedde, Steven J.; Brandt, James D; Kira, David; Feuer, William; Larson, Eric.

In: Ophthalmology, Vol. 111, No. 12, 12.2004, p. 2204-2210.

Research output: Contribution to journalArticle

Budenz, DL, Gedde, SJ, Brandt, JD, Kira, D, Feuer, W & Larson, E 2004, 'Baerveldt glaucoma implant in the management of refractory childhood glaucomas', Ophthalmology, vol. 111, no. 12, pp. 2204-2210. https://doi.org/10.1016/j.ophtha.2004.05.017
Budenz, Donald L. ; Gedde, Steven J. ; Brandt, James D ; Kira, David ; Feuer, William ; Larson, Eric. / Baerveldt glaucoma implant in the management of refractory childhood glaucomas. In: Ophthalmology. 2004 ; Vol. 111, No. 12. pp. 2204-2210.
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abstract = "Purpose To evaluate the effectiveness and safety of the Baerveldt glaucoma drainage implant (GDI) in the management of pediatric glaucomas. Design Retrospective noncomparative case series. Participants Sixty-two children younger than 18 years who underwent Baerveldt GDI surgery. Main outcome measures Intraocular pressure (IOP), intraoperative and postoperative complications, number of glaucoma medications, and VA. Success was defined as IOP of <22 mmHg and ≥5 mmHg with or without medications, no loss of light perception, and no further surgical intervention for glaucoma. Outcomes were compared for patients with primary and secondary glaucomas. Results Sixty-two eyes of 62 patients were identified. The mean patient age (± standard deviation) at time of Baerveldt glaucoma implant surgery was 6.5±5.6 years (range, 6 weeks-17 years). With an average follow-up of 23.4±21.7 months (range, 1-106), IOP was reduced from a mean of 35.0±8.7 mmHg (range, 17-54) preoperatively to 17.6±8.4 mmHg (range, 5-45) at last follow-up visit (P<0.001). Kaplan-Meier survival analysis showed a cumulative success of 85{\%} at 6 months, 80{\%} at 12 months, 67{\%} at 24 months, and 60{\%} in months 28 through 106. There was no difference between primary (N = 23) and secondary glaucoma (N = 39) patients in terms of length of follow-up, final IOP, number of medications, or cumulative success (P = 0.21). Conclusion Baerveldt glaucoma implant surgery seems to be an effective treatment for primary and secondary refractory glaucomas in children. There is a risk of retinal detachment that may be related to the implant or other ocular conditions.",
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N2 - Purpose To evaluate the effectiveness and safety of the Baerveldt glaucoma drainage implant (GDI) in the management of pediatric glaucomas. Design Retrospective noncomparative case series. Participants Sixty-two children younger than 18 years who underwent Baerveldt GDI surgery. Main outcome measures Intraocular pressure (IOP), intraoperative and postoperative complications, number of glaucoma medications, and VA. Success was defined as IOP of <22 mmHg and ≥5 mmHg with or without medications, no loss of light perception, and no further surgical intervention for glaucoma. Outcomes were compared for patients with primary and secondary glaucomas. Results Sixty-two eyes of 62 patients were identified. The mean patient age (± standard deviation) at time of Baerveldt glaucoma implant surgery was 6.5±5.6 years (range, 6 weeks-17 years). With an average follow-up of 23.4±21.7 months (range, 1-106), IOP was reduced from a mean of 35.0±8.7 mmHg (range, 17-54) preoperatively to 17.6±8.4 mmHg (range, 5-45) at last follow-up visit (P<0.001). Kaplan-Meier survival analysis showed a cumulative success of 85% at 6 months, 80% at 12 months, 67% at 24 months, and 60% in months 28 through 106. There was no difference between primary (N = 23) and secondary glaucoma (N = 39) patients in terms of length of follow-up, final IOP, number of medications, or cumulative success (P = 0.21). Conclusion Baerveldt glaucoma implant surgery seems to be an effective treatment for primary and secondary refractory glaucomas in children. There is a risk of retinal detachment that may be related to the implant or other ocular conditions.

AB - Purpose To evaluate the effectiveness and safety of the Baerveldt glaucoma drainage implant (GDI) in the management of pediatric glaucomas. Design Retrospective noncomparative case series. Participants Sixty-two children younger than 18 years who underwent Baerveldt GDI surgery. Main outcome measures Intraocular pressure (IOP), intraoperative and postoperative complications, number of glaucoma medications, and VA. Success was defined as IOP of <22 mmHg and ≥5 mmHg with or without medications, no loss of light perception, and no further surgical intervention for glaucoma. Outcomes were compared for patients with primary and secondary glaucomas. Results Sixty-two eyes of 62 patients were identified. The mean patient age (± standard deviation) at time of Baerveldt glaucoma implant surgery was 6.5±5.6 years (range, 6 weeks-17 years). With an average follow-up of 23.4±21.7 months (range, 1-106), IOP was reduced from a mean of 35.0±8.7 mmHg (range, 17-54) preoperatively to 17.6±8.4 mmHg (range, 5-45) at last follow-up visit (P<0.001). Kaplan-Meier survival analysis showed a cumulative success of 85% at 6 months, 80% at 12 months, 67% at 24 months, and 60% in months 28 through 106. There was no difference between primary (N = 23) and secondary glaucoma (N = 39) patients in terms of length of follow-up, final IOP, number of medications, or cumulative success (P = 0.21). Conclusion Baerveldt glaucoma implant surgery seems to be an effective treatment for primary and secondary refractory glaucomas in children. There is a risk of retinal detachment that may be related to the implant or other ocular conditions.

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