Baerveldt implant in refractory glaucoma: long-term results and factors influencing outcome

Purpose: To evaluate the clinical outcome of patients who received aBaerveldt implant for refractory glaucoma and to identify factors which mayinfluence the outcome. Methods: Retrospective study including 51 eyesof 51 patients with medically uncontrolled glaucoma who underwent Baerveldtimplant surgery between June 1994 and December 1998. Criteria for successwere intraocular pressure (IOP) 21 mmHg and >6 mmHg, necessityof further antiglaucoma medications, absence of additional glaucoma surgeryand no loss of light perception. Results: Over a mean follow-up of 37.6(SD: ± 18.8) months, the mean intraocular pressure decreased from 34.8(±12.5) mmHg to 14.0 (±4.3) mmHg at month 60. Qualified successrate, achieved when IOP was below 21 mmHg and higher than 6 mmHg withmedications was 25/48 (52%), complete success rate (same IOP limits withoutmedication) was 14/48 (29%). Seven eyes had major complications or lostlight perception. Postoperative visual acuity improved or remained within oneSnellen line of the preoperative visual acuity in 35 patients (73%). Factorsassociated with a better prognosis were a preoperative visual acuity better than 20/400 and etiology of glaucoma. Conclusion: The Baerveldt implant iseffective in lowering intraocular pressure in most patients with refractoryglaucoma. Long-term results are promising with satisfactory IOP control.