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1 General aspects (0)   1.1 Epidemiology (10)   1.2 Population genetics (7)   1.3 Pathogenesis (3)   1.4 Quality of life (3)   1.5 Glaucomas as cause of blindness (2)   1.6 Prevention and screening (5) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (0)   2.2 Cornea (1)   2.3 Sclera (0)   2.4 Anterior chamber angle (0)   2.5 Meshwork (3)     2.5.1 Trabecular meshwork (10)     2.5.2 Schlemms canal (0)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (1)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (3)   2.7 Episcleral veins and venous pressure (1)   2.8 Iris (4)   2.9 Ciliary body (3)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (2)   2.13 Retina and retinal nerve fibre layer (20)   2.14 Optic disc (18)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (1)   2.17 Stem cells (0)   2.20 Other (0) 3 Laboratory methods (2)   3.1 Microscopy (3)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (8)   3.4 Molecular genetics (2)     3.4.1 Linkage studies (8)     3.4.2 Gene studies (3)   3.5 Molecular biology incl. SiRNA (9)   3.6 Cellular biology (6)   3.7 Biochemistry (3)   3.8 Pharmacology (5)   3.9 Pathophysiology (2)   3.10 Immunobiology (0)   3.11 Pharmacogenetics (0)   3.12 Proteomics (0)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (0)     3.13.4 Other (0)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (20)   5.1 Rodent (0)   5.2 Primates (0)   5.3 Other (0) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (11)     6.1.1 Devices, techniques (0)     6.1.2 Fluctuation, circadian rhythms (0)     6.1.3 Factors affecting IOP (0)   6.2 Tonography, aqueous flow measurement (see also 2.6) (1)   6.3 Biomicroscopy (slitlamp) (0)     6.3.1 Anterior segment (0)     6.3.2 Posterior segment (0)   6.4 Gonioscopy (0)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (2)     6.6.1 Conventional manual (1)     6.6.2 Automated (9)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (11)   6.7 Electro-ophthalmodiagnosis (8)   6.8 Photography (0)     6.8.1 Anterior segment (1)     6.8.2 Posterior segment (5)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (17)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       6.9.1.2 Confocal Scanning Laser Polarimetry (0)     6.9.2 Optical coherence tomography (8)       6.9.2.1 Anterior (0)       6.9.2.2 Posterior (0)     6.9.5 Other (1)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (0)   6.11 Bloodflow measurements (12)   6.12 Ultrasonography and ultrasound biomicroscopy (2)   6.13 Provocative tests (0)   6.19 Telemedicine (0)   6.20 Progression (2)   6.30 Other (0) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (0)   8.2 Hypermetropia (0)   8.3 Contact lenses (1)   8.4 Refractive surgical procedures (0)   8.5 Other (0) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (3)     9.1.1 Congenital glaucoma, Buphthalmos (0)     9.1.2 Juvenile glaucoma (0)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (4)     9.1.4 Other (0)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (0)     9.2.2 Other risk factors for glaucoma (8)     9.2.3 Open angle glaucoma with elevated IOP (1)     9.2.4 Normal pressure glaucoma (6)   9.3 Primary angle closure glaucomas (1)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (2)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (2)     9.3.3 Plateau iris syndrome (1)     9.3.4 Primary angle closure suspect (0)     9.3.5 Primary angle closure (0)     9.3.10 Other (1)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (0)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (0)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (1)       9.4.3.1 Pigmentary glaucoma (6)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (2)       9.4.4.2 Glaucomas associated with cataracts (1)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (2)       9.4.5.5 Other (0)     9.4.6 Glaucomas associated with inflammation, uveitis (0)     9.4.7 Glaucomas associated with ocular trauma (0)     9.4.8 Glaucomas associated with intraocular tumors (0)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (1)       9.4.10 Glaucomas associated with hemorrhage (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (0)       9.4.11.2 Glaucomas in aphakia and pseudophakia (1)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (3)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (0)     9.4.15 Glaucoma in relation to systemic disease (4)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (4) 11 Medical treatment (0)   11.1 General management, indication (8)   11.2 Cholinergic drugs (4)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (4)     11.3.4 Betablocker (12)     11.3.5 Other (1)   11.4 Prostaglandins (31)   11.5 Carbonic anhydrase inhibitors (0)     11.5.1 Systemic (0)     11.5.2 Topical (7)   11.6 Osmotic treatment (1)   11.7 Treatment of bloodflow (1)   11.8 Neuroprotection (7)   11.9 Gene therapy (2)   11.13 Combination therapy (0)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (0)     11.13.3 Betablocker and brimonidine (0)     11.13.4 Betablocker and prostaglandin (0)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (7)   11.15 Other drugs in relation to glaucoma (0)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (1)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (0)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (5)   12.2 Laser iridotomy (0)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (1)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (1)     12.8.1 Without tube implant (4)     12.8.2 With tube implant or other drainage devices (11)     12.8.3 Non-perforating (13)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (10)     12.8.11 Complications, endophthalmitis (6)   12.9 Trabeculotomy, goniotomy (1)   12.10 Cyclodestruction (3)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (1)     12.12.3 Phacoemulsification (2)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (6)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (0)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (5) 15 Miscellaneous (2)

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Abstract #9046 Published in IGR 5-2

Intermediate-term outcome of Baerveldt glaucoma implants in Asian eyes

Seah S; Gazzard G; Aung T
Ophthalmology 2003; 110: 888-894

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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 and twenty-four Asian patients (124 eyes) with complicated glaucoma. INTERVENTION: Implantation of 54 250-mm² and 70 350-mm² Baerveldt glaucoma drainage implants at Singapore National Eye Center from 1994 through 1999. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), number of glaucoma medications, and complications. RESULTS: The mean follow-up period was 33.4 ± 14.4 months (mean ± SD; range, 12-72 months). IOP was reduced from a mean preoperative level 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- and 350-mm² 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.

Dr. S.K. Seah, Singapore National Eye Centre, Singapore, Republic of Singapore

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Classification:

12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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