Journal of Current Glaucoma Practice

Register      Login

VOLUME 11 , ISSUE 1 ( January-April, 2017 ) > List of Articles

Original Article

Retrospective Comparison of Intermediate-term Efficacy of 350 mm2 Glaucoma Drainage Implants and Medium-sized 230—250 mm2 Implants

Alissa M Meyer, Cooper D Rodgers, Baiming Zou, Nicole C Rosenberg, Aaron D Webel, Mark B Sherwood

Keywords : Baerveldt, Glaucoma, Glaucoma drainage device, Intraocular pressure, Molteno, Retrospective study, Visual acuity

Citation Information : Meyer AM, Rodgers CD, Zou B, Rosenberg NC, Webel AD, Sherwood MB. Retrospective Comparison of Intermediate-term Efficacy of 350 mm2 Glaucoma Drainage Implants and Medium-sized 230—250 mm2 Implants. J Curr Glaucoma Pract 2017; 11 (1):8-15.

DOI: 10.5005/jp-journals-10008-1214

License: CC BY-NC 4.0

Published Online: 00-04-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To compare the intermediate-term efficacy of a large surface area Baerveldt 350 mm2 glaucoma drainage device (GDD) with medium surface area implants (Baerveldt 250 mm2 and Molteno 3, 230, or 245 mm2). Design: This is a retrospective, nonrandomized comparative trial. Materials and methods: A total of 94 eyes of 94 patients of mixed glaucoma diagnoses without any prior glaucoma surgical procedures and who had undergone a glaucoma drainage implant surgery with either a large Baerveldt 350 mm2 GDD or a medium-sized GDD (Baerveldt 250 mm2 or Molteno 230 or 245 mm2) were reviewed for intraocular pressure (IOP), number of glaucoma medications, and visual acuity (VA) preoperatively, and at 1, 2, and 3 years postprocedure. Results: No significant differences were found in mean IOP, number of glaucoma medications used, and VA at 1, 2, and 3 years postoperatively. The rate of additional glaucoma procedures was similar between the two groups. Conclusion: There is no clear evidence that a larger implant surface area beyond 230 to 250 mm2 is advantageous in providing intermediate-term IOP control. Clinical significance: It may be technically easier to surgically place a GDD that does not need to have its wings placed underneath the recti muscles, and the IOP results are similar. How to cite this article: Meyer AM, Rodgers CD, Zou B, Rosenberg NC, Webel AD, Sherwood MB. Retrospective Comparison of Intermediate-term Efficacy of 350 mm2 Glaucoma Drainage Implants and Medium-sized 230—250 mm2 Implants. J Curr Glaucoma Pract 2017;11(1):8-15.


PDF Share
  1. DeBry PW, Perkins TW, Heatley G, Kaufman P, Brumback LC. Incidence of late-onset bleb-related complications following trabeculectomy with mitomycin. Arch Ophthalmol 2002 Mar;120(3):297-300.
  2. Inaba Z. Long-term results of trabeculectomy in the Japanese: an analysis by life-table method. Jpn J Ophthalmol 1982;26(4): 361-373.
  3. Schwartz AL, Anderson DR. Trabecular surgery. Arch Ophthalmol 1974 Aug;92(2):134-138.
  4. Law SK, Shih K, Tran DH, Coleman AL, Caprioli J. Long-term outcomes of repeat vs initial trabeculectomy in open-angle glaucoma. Am J Ophthalmol 2009 Nov;148(5):685-695.e1.
  5. Heuer DK, Lloyd MA, Abrams DA, Baerveldt G, Minckler DS, Lee MB, Martone JF. Which is better? One or two? A randomized clinical trial of single-plate versus double-plate Molteno implantation for glaucomas in aphakia and pseudophakia. Ophthalmology 1992 Oct;99(10):1512-1519.
  6. Budenz DL, Barton K, Gedde SJ, Feuer WJ, Schiffman J, Costa VP, Godfrey DG, Buys YM, Ahmed Baerveldt Comparison Study Group. Five-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology 2015 Feb;122(2):308-316.
  7. Christakis PG, Kalenak JW, Tsai JC, Zurakowski D, Kammer JA, Harasymowycz PJ, Mura JJ, Cantor LB, Ahmed II. The Ahmed versus Baerveldt study: five-year treatment outcomes. Ophthalmology 2016 Oct;123(10):2093-2102.
  8. Engel LA, Muether PS, Fauser S, Hueber A. The effect of previous surgery and topical eye drops for primary open-angle glaucoma on cytokine expression in aqueous humor. Graefes Arch Clin Exp Ophthalmol 2014 May;252(5):791-799.
  9. Freedman J, Iserovich P. Pro-inflammatory cytokines in glaucomatous aqueous and encysted Molteno implant blebs and their relationship to pressure. Invest Ophthalmol Vis Sci 2013 Jul 18;54(7):4851-4855.
  10. Smith MF, Doyle JW, Sherwood MB. Comparison of the Baerveldt glaucoma implant with the double-plate Molteno drainage implant. Arch Ophthalmol 1995 Apr;113(4):444-447.
  11. Allan EJ, Khaimi MA, Jones JM, Ding K, Skuta GL. Longterm efficacy of the Baerveldt 250 mm2 compared with the Baerveldt 350 mm2 implant. Ophthalmology 2015 Mar;122(3): 486-493.
  12. Seah SKL, Gazzard G, Aung T. Intermediate-term outcome of Baerveldt glaucoma implants in Asian eyes. Ophthalmology 2003 May;110(5):888-894.
  13. Holladay JT. Proper method for calculating average visual acuity. J Refract Surg 1997 Jul-Aug;13(4):388-391.
  14. Watt WS. How visual acuity is measured. Living well with low vision; 2003. Accessed 2016 Sep 8. Available from: http://lowvision.preventblindness.org/eye-conditions/how-visual-acuity-is-measured/.
  15. Britt MT, Labree LD, Lloyd MA, Minckler DS, Heuer DK, Baerveldt G, Varma R. Randomized clinical trial of the 350-mm2 versus the 500-mm2 Baerveldt implant: longer term results. Is bigger better? Ophthalmology 1999 Dec; 106(12):2312-2318.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.