Long-term outcomes of Baerveldt glaucoma implant surgery in Japanese patients

Abstract

Abstract This study evaluated the long-term surgical outcomes of Baerveldt glaucoma implant (BGI) surgery in patients with refractory glaucoma (233 eyes/204 patients). Surgical failure was defined by: <20% reduction in preoperative intraocular pressure (IOP), or criterion A (IOP > 21 mmHg), criterion B (IOP > 17 mmHg), or criterion C (IOP > 14 mmHg). Reoperation, loss of light perception vision, or hypotony also denoted failure. The probability of success at 5 years postoperatively using criteria A, B, and C was 71.5%, 48.4%, and 22.0%, respectively. The mean IOP decreased significantly from 32.8 ± 9.4 mmHg preoperatively to 13.4 ± 4.1 mmHg at 5 years; the mean number of glaucoma medications also decreased from 3.7 ± 1.2 to 1.9 ± 1.9 (both P < 0.01). The number of previous intraocular surgeries was significantly associated with failure in the multivariable analysis for criterion B (hazard ratio: 1.28; P < 0.01). Early and late postoperative complications occurred in 93 (39.9%) and 33 (14.2%) eyes, respectively. Postoperative interventions were performed in 55 eyes (23.6%). BGI surgery resulted in significant long-term decreases in IOP and the number of glaucoma medications. BGI surgery is effective for refractory glaucoma. However, postoperative interventions due to complications are required in numerous cases.