Long-term intraocular pressure control and corneal graft survival in eyes with a pars plana Baerveldt implant and corneal transplant

J Glaucoma. 2010 Feb;19(2):124-31. doi: 10.1097/IJG.0b013e3181a98cc1.

Abstract

Purpose: To investigate long-term intraocular pressure (IOP) control and corneal graft survival in eyes with a valveless Baerveldt glaucoma drainage implant (GDI) through the pars plana (PP) and a penetrating keratoplasty (PK).

Methods: We reviewed the medical records of 48 patients (51 eyes) who underwent PP placement of a GDI and a PK between July 1996 and June 2006 at the University of Virginia. The GDI was inserted during the same operation as the PK in 26 eyes (51.0%). Glaucoma control was assessed by IOP and the need for further glaucoma medication or surgery. Corneal grafts were assessed for clarity.

Results: Mean follow-up was 38.4 months. IOP was successfully controlled in 88%, 85%, and 82% of eyes at 12, 24, and 48 months, respectively. Corneal grafts were clear in 89%, 67%, and 41% of eyes at 12, 24, and 48 months, respectively. Corneal graft failure was significantly higher in eyes with an anterior chamber intraocular lens (P<or=0.01), and in eyes with a diagnosis of chronic angle closure glaucoma (P=0.04).

Conclusions: PP insertion of a valveless GDI tube, in eyes with a previous or concurrent PK, is an effective way to control IOP in eyes with medically uncontrolled glaucoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Corneal Diseases / complications
  • Corneal Diseases / surgery*
  • Female
  • Follow-Up Studies
  • Glaucoma / complications
  • Glaucoma / surgery*
  • Glaucoma Drainage Implants*
  • Graft Survival / physiology*
  • Humans
  • Intraocular Pressure / physiology*
  • Keratoplasty, Penetrating*
  • Male
  • Middle Aged
  • Risk Factors
  • Tonometry, Ocular
  • Visual Acuity / physiology