Baerveldt implant may be useful in pediatric glaucoma cases

If angle surgery has failed or has been deemed inappropriate for pediatric patients with glaucoma, the Baerveldt glaucoma implant may be a viable option, according to a Dutch study. Surgeons, however, should be prepared to handle any tube-related problems this type of surgery may cause, the authors suggest.

K.A. van Overdam and colleagues at the Rotterdam Eye Hospital retrospectively reviewed 55 eyes of 40 pediatric patients with primary or secondary glaucoma who underwent Baerveldt implantation. All patients were under 16 years old at baseline. The follow-up ranged from 2 to 78 months, with a mean of 32 months.

Cumulatively, the success rate was 94% at 12 and 24 months, dropping to 85% at 36 months, 78% at 48 months and 44% at 60 months. Of the eyes, eight failed postoperatively because the IOP was more than 21 mm Hg, two had persistent hypotony, and one had choroidal hemorrhage following cataract surgery. The most frequent complication that required surgical correction was tube-related, the researchers said. Entrapment of a tuft of peripheral iris in the tube track caused mild to moderate dyscoria in 22% of the eyes, all buphthalmic.

The study is published in the March issue of British Journal of Ophthalmology.