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Quang H. Nguyen, MD; Donald L. Budenz, MD; Richard K. Parrish II, MD

Arch Ophthalmol. 1998;116:571-575.

Objectives  To report the incidence and identify risk factors of postoperative complications after Baerveldt glaucoma drainage implantation.

Methods  A retrospective review of the medical records of all patients at the Bascom Palmer Eye Institute, Miami, Fla, who underwent placement of a Baerveldt glaucoma drainage implant from October 1, 1992, through October 31, 1996, to determine demographic characteristics, preoperative and postoperative intraocular pressures, and complications. Variables were analyzed using the Student t test and Fisher exact test to determine the association between delayed postoperative suprachoroidal hemorrhage and various potential risk factors.

Results  A total of 107 eyes of 103 patients were identified. Suprachoroidal hemorrhage occurred in 4 eyes (4%), with onset ranging from 3 to 33 days after implantation. Two eyes (2%) had choroidal effusions requiring surgical drainage, and 20 eyes (19%) had low choroidal effusions requiring only close observation. Tube blockage was observed in 5 eyes (5%). Four eyes (4%) had aqueous misdirection, 2 eyes (2%) had corneal decompensation, and 1 eye (1%) each had endophthalmitis, tube migration, corneal ulcer, hyphema, and implant migration. Patients who were older (P=.04) or had postoperative choroidal effusions (P=.03), low intraocular pressure immediately after the tube opened (P=.03), hypertension (P=.08), or atherosclerosis (P=.09) were more likely to develop suprachoroidal hemorrhage.

Conclusions  A lower incidence of serious postoperative complications was observed in Baerveldt implantations in this study when compared with a recent report. Risk factors for serious complications were similar to trabeculectomy.

From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla. Dr Nguyen is now with the Department of Ophthalmology, University of Colorado Health Science Center, Denver. The authors have no commercial or proprietary interest in the Baerveldt implant or its manufacturer, Pharmacia/Upjohn, Kalamazoo, Mich.

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