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Long-term Intraocular Pressure Control and Corneal Graft Survival in Eyes With a Pars Plana Baerveldt Implant and Corneal Transplant

Witmer, Matthew T. MD; Tiedeman, James S. MD, PhD; Olsakovsky, Leslie A. MD; Conaway, Mark R. PhD; Prum, Bruce E. MD

doi: 10.1097/IJG.0b013e3181a98cc1
Original Studies
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Purpose To investigate long-term intraocular pressure (IOP) control and corneal graft survival in eyes with a valveless Baerveldt glaucoma drainage implant (GDI) through the pars plana (PP) and a penetrating keratoplasty (PK).

Methods We reviewed the medical records of 48 patients (51 eyes) who underwent PP placement of a GDI and a PK between July 1996 and June 2006 at the University of Virginia. The GDI was inserted during the same operation as the PK in 26 eyes (51.0%). Glaucoma control was assessed by IOP and the need for further glaucoma medication or surgery. Corneal grafts were assessed for clarity.

Results Mean follow-up was 38.4 months. IOP was successfully controlled in 88%, 85%, and 82% of eyes at 12, 24, and 48 months, respectively. Corneal grafts were clear in 89%, 67%, and 41% of eyes at 12, 24, and 48 months, respectively. Corneal graft failure was significantly higher in eyes with an anterior chamber intraocular lens (P≤0.01), and in eyes with a diagnosis of chronic angle closure glaucoma (P=0.04).

Conclusions PP insertion of a valveless GDI tube, in eyes with a previous or concurrent PK, is an effective way to control IOP in eyes with medically uncontrolled glaucoma.

Departments of *Ophthalmology

Biostatistics and Epidemiology, University of Virginia Health Sciences Center, Charlottesville, VA

Reprints: Matthew T. Witmer, MD, Department of Ophthalmology, University of South Florida Eye Institute, 12901 Bruce B. Downs Blvd. MDC 21, Tampa, FL 33612 (e-mail: mwitmer@health.usf.edu).

Received for publication August 24, 2008

accepted March 28, 2009

Presented in part at: Association of Vision and Research in Ophthalmology Annual Meeting, May 2007; Fort Lauderdale, FL.

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