A Retrospective Comparison of Primary Baerveldt Implantation Versus Trabeculectomy with Mitomycin C

Overview

Journal Ophthalmology

Publisher Elsevier

Specialty Ophthalmology

Date 2016 Jan 10

PMID 26746596

Citations 19

Authors

Joseph F Panarelli

Michael R Banitt

Steven J Gedde

Wei Shi

Joyce C Schiffman

William J Feuer

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the safety and efficacy of Baerveldt implantation (Abbott Medical Optics, Santa Ana, CA) and trabeculectomy with mitomycin C (MMC) in patients who have not undergone prior incisional ocular surgery.

Design: Retrospective, comparative case series.

Participants: A total of 125 patients with low-risk glaucoma undergoing primary glaucoma surgery, including 55 patients who received a 350-mm(2) Baerveldt glaucoma implant and 70 patients who underwent trabeculectomy with MMC.

Methods: Eligible patients were identified using Current Procedural Terminology codes, and their medical records were reviewed retrospectively.

Main Outcome Measures: The primary outcome measure was surgical success (intraocular pressure [IOP] ≤21 mmHg and reduced ≥20% from baseline, IOP >5 mmHg, no reoperation for glaucoma, no loss of light-perception vision). Secondary outcome measures included visual acuity, IOP, number of glaucoma medications, and complications.

Results: The cumulative probability of success at 3 years with or without medical therapy was 87% in the Baerveldt group and 76% in the trabeculectomy group (P = 0.23). Postoperative complications occurred in 11 patients (20%) in the Baerveldt group and 20 patients (29%) in the trabeculectomy group (P = 0.27). Mean follow-up ± standard deviation was 27±19 months in the Baerveldt group and 34±20 months in the trabeculectomy group (P = 0.053).

Conclusions: Similar rates of surgical success and postoperative complications were observed in patients undergoing trabeculectomy with MMC and in those undergoing Baerveldt implantation during 3 years of follow-up. Both are viable primary glaucoma procedures in patients who have not undergone prior ocular surgery.

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