Baerveldt implantation, trabeculectomy yield similar results after primary glaucoma surgery

Baerveldt implantation and trabeculectomy with mitomycin C may have similar surgical success rates in primary incisional glaucoma surgery, according to a study.

The retrospective, comparative case series reviewed 125 low-risk glaucoma cases with no prior incisional ocular surgery, in which 55 patients received a 350 mm² Baerveldt glaucoma implant (Abbott Medical Optics) and 70 patients underwent trabeculectomy with MMC.

Mean follow-up was 27 ± 19 months in the Baerveldt group and 34 ± 20 months in the trabeculectomy group.

Both groups had significant and sustained reductions in IOP during the follow-up; however, postoperative IOP was lower at all follow-up points in the trabeculectomy group vs. the Baerveldt group.

Additionally, patients who underwent trabeculectomy needed significantly fewer medications vs. those with the tube shunt.

At 3 years, the cumulative probability of qualified success was 87% in the Baerveldt group and 76% in the trabeculectomy group; the difference was not significant. Inadequate IOP reduction was the primary cause for failure in both groups.

Rates of vision loss, postoperative complications, reoperation and cataract extraction were similar in both groups during follow-up.

“Multiple factors must be considered when selecting a glaucoma procedure, including the patient’s tolerance of glaucoma medical therapy, target level of IOP reduction, risk of postoperative complications, and surgeon’s experience and comfort with each procedure,” the study authors said. – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.

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Source:

Panarelli JF, et al. Ophthalmology. 2016;doi:10.1016/j.ophtha.2015.11.017.