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Abstract #3646 Published in IGR 4-2
Tube fenestrations in Baerveldt glaucoma implant surgery: one-year results compared with standard implant surgery
Emerick GT; Gedde SJ; Budenz DLJournal of Glaucoma 2002; 11: 340-346
PURPOSE: To evaluate the efficacy and safety of tube fenestrations in eyes undergoing polyglactin suture-ligated Baerveldt glaucoma implant surgery. PATIENTS AND METHODS: The authors performed a retrospective nonrandomized comparative interventional study of consecutive cases of 111 eyes of 111 patients with refractory glaucoma who received polyglactin (Vicryl) suture-ligated Baerveldt 350 implants as a single procedure. In 69 of these cases (group 1), fenestrations were placed anterior to the ligature using a suture needle. In 42 cases (group 2), no fenestrations were performed. Main outcome measures included intraocular pressure (IOP), visual acuity, and complications. RESULTS: Mean (± SD) preoperative IOP was 36.7 ± 10.2 mmHg in group 1 and 28.3 ± 10.3 mmHg in group 2 (p < 0.001). Postoperative mean IOP was lower in group 1 than in group 2 at day 1 (20.2 ± 12.8 versus 29.3 ± 1.9 mmHg, p < 0.001) and week 1 (18.3 ± 10.4 versus 23.7 ± 8.6 mmHg, p = 0.006), but was virtually identical at one year (12.7 ± 4.9 versus 12.6 ± 4.4 mmHg, p = 0.95). Number of glaucoma medications used by group 1 patients was significantly lower up to three months (p = 0.05). Complication rates were similar in both groups. After tube opening at a mean of 36 ± 4.7 days, there was an equal and sustained IOP reduction in both groups in patients taking a similar number of glaucoma medicines up to 12 months after surgery. CONCLUSIONS: Tube fenestrations provide safe and effective short-term IOP control with fewer glaucoma medications in a ligated non-valved glaucoma drainage implant, with comparable IOP control and medications required at one year. However, not all patients have sustained reduction of IOP in the immediate postoperative period with fenestrations, making the effect somewhat unpredictable.
Dr. D.L. Budenz, Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136, USA. dbudenz@med.miami.edu
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
