Initial experience with pneumatically stented baerveldt implant modified for pars plana insertion for complicated glaucoma.

Abstract

To assess the efficacy of pneumatically stented drainage tube implants specially modified for pars plana insertion in the treatment of complicated glaucoma. Retrospective, non-comparative case series. 50 consecutive patients with refractory complicated glaucoma nonresponsive to medical treatment. Baerveldt glaucoma implants modified by Hofmann for pars plana insertion were placed following pars plana vitrectomy and gas-fluid exchange (pneumatically stented implant, or PSI procedure). Reduction of intraocular pressure (IOP) to 21 mmHg or less. 31 neovascular and 19 complicated non-neovascular glaucoma eyes in 48 patients referred to a vitreoretinal subspecialty practice, average age 69 years (range 29-91), were followed an average of 18 months (range 3-41). The average preoperative IOP was 44 mmHg (14-78) on an average 3.2 glaucoma medications (range 2-6). The average final postoperative IOP was 14 mmHg (range 5-31) on an average 0.6 glaucoma medications (range 0-3, median 0). The final intraocular pressure was 21 mmHg or less in 47 of 50 (94%) operated eyes. Serious complications related to the procedure occurred in five eyes (10%). Pneumatically stented Baerveldt glaucoma implants modified with the Hofmann elbow to facilitate pars plana insertion are effective in the treatment of complicated glaucoma.