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Ingrid U. Scott, MD, MPH; Steven J. Gedde, MD; Donald L. Budenz, MD; David S. Greenfield, MD; Harry W. Flynn, Jr, MD; William J. Feuer, MS; Mozart O. Mello, Jr, MD; Rohit Krishna, MD; David G. Godfrey, MD

Arch Ophthalmol. 2000;118:1509-1513.

Objective  To describe the surgical insertion of a Baerveldt drainage implant and postoperative visual acuity and intraocular pressure (IOP) outcomes in patients with a preexisting scleral buckle.

Methods  Medical records of all patients with a preexisting scleral buckle who underwent insertion of a Baerveldt drainage implant at Bascom Palmer Eye Institute, Miami, Fla, from January 1, 1994, through December 31, 1998, were reviewed. Outcome measures included visual acuity and IOP at 1 year.

Results  At 1 year postoperatively, 14 (88%) of 16 patients had stable or improved visual acuity. Preoperatively, mean IOP was 30.9 mm Hg and the mean number of antiglaucoma medications was 3.4; at 1 year postoperatively, mean IOP was 12.0 mm Hg and the mean number of antiglaucoma medications was 0.8 (P<.001). Nine patients (56%) achieved an IOP of greater than 5 and no greater than 21 mm Hg without medication, and an additional 7 (44%) achieved this level of IOP control with medication. No patient required further surgery for uncontrolled IOP during the follow-up interval, which ranged from 19.1 to 45.5 months.

Conclusion  Baerveldt drainage device insertion behind or over a preexisting encircling band is often successful in managing refractory glaucoma in patients who have undergone previous scleral buckling procedures.

From the Departments of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla (Drs Scott, Gedde, Budenz, Greenfield, Flynn, Mello, and Godfrey and Mr Feuer), and Kansas City School of Medicine, University of Missouri, Kansas City (Dr Krishna). Dr Godfrey is now affiliated with Glaucoma Associates of Texas, Dallas.

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