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PURPOSE: To report the outcome and complications of ten eyes of nine children with Sturge-Weber syndrome (SWS) who underwent two-stage insertion of a Baerveldt glaucoma implant (BGI) for glaucoma. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: The authors reviewed the medical records of children under the age of 14 years with SWS who underwent two-stage BGI for glaucoma at two tertiary care referral centers. MAIN OUTCOME MEASURES: Intraoperative and postoperative complications, intraocular pressure (IOP), number of glaucoma medications, visual acuity, and further surgical intervention. RESULTS: Ten eyes of nine patients were included in the study. Ages of the nine patients at time of first stage BGI ranged between six weeks and 13 years. With average follow-up of 35 months (range, 10-50 months), all eyes had adequate IOP control (≤21 mmHg) without the need for additional glaucoma surgery. Intraocular pressure was reduced from a mean (± standard deviation) of 24.8 ± 6.2 mmHg preoperatively to 16.9 ± 2.3 mmHg at last follow-up visit (p = 0.001). The number of medications used for control of glaucoma was reduced from a mean (± standard deviation) of 1.8 ± 1.0 preoperatively to 1.1 ± 1.4 at the last follow-up visit (p = 0.2). One eye had serous choroidal effusions with overlying serous retinal detachment that resolved spontaneously after seven days with no permanent visual loss, and one eye had low choroidal effusion that lasted for four days. There were no intraoperative or postoperative suprachoroidal hemorrhages. At last follow-up, visual acuity had improved by one or more lines in all patients in whom vision was measurable. CONCLUSIONS: Two-stage BGI surgery appears to be a safe and effective treatment for refractory glaucoma in children with SWS.
Dr. D.L. Budenz, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, FL, USA
9.4.9 Glaucomas associated with elevated episcleral venous pressure (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)