Experience with the Baerveldt glaucoma implant in the management of pediatric glaucoma

PURPOSE: To report the clinical outcome in 48 eyes of 48 children who received a Baerveldt glaucoma implant (BGI) for the management of pediatric glaucoma.DESIGN: Retrospective, noncomparative case series.METHODS: the medical records of all patients with pediatric glaucoma who underwent a BGI at two tertiary care referral centers in Los Angeles between 1990 and 1999 were reviewed. Intraocular pressure (IOP), intraoperative and postoperative complications, number of glaucoma medications, visual acuity, and pre- and postoperative corneal diameter and axial length were collected from patient records. Criteria for success were IOP between 6 and 21 mm Hg with or without glaucoma medications, no need for further glaucoma surgery, the absence of visually threatening complications, and some residual vision (minimum visual acuity of light perception).RESULTS: the study included 48 eyes from 48 patients aged 16 years and younger (mean age 4.1 years). Mean preoperative IOP was 31.2 ± 25.7 mm Hg, and mean postoperative IOP was 16.4 ± 4.9 mm Hg. Cumulative probability of success (based on the Kaplan-Meier survival curve) was 95% at 6 months, 90% at 1 year, 84% at 2 years, 74% at 36 months, and 58% at 48 months. On average, the BGIs were successful for a mean period of 5.6 years (67.7 months). Overall, 11 eyes failed, with the causes being uncontrolled IOP (eight eyes), retinal detachment (two eyes), and no light perception (one eye).CONCLUSIONS: Baerveldt glaucoma implants can be a safe and effective treatment modality for the management of pediatric glaucoma refractive to medical therapy. © 2005 by Elsevier Inc. All rights reserved.Univ So Calif, Keck Sch Med, Doheny Eye Inst, Los Angeles, CA 90033 USAUniv So Calif, Keck Sch Med, Dept Ophthalmol, Dept Prevent Med, Los Angeles, CA 90033 USAChildrens Hosp Los Angeles, Los Angeles, CA 90027 USAUniversidade Federal de São Paulo, Paulista Sch Med, Dept Ophthalmol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Dept Ophthalmol, São Paulo, BrazilWeb of Scienc