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Retrospective Review of Pars Plana Versus Anterior Chamber Placement of Baerveldt Glaucoma Drainage Device

Rososinski, Anthony MBBS (SYD) MBA*; Wechsler, David MBBS (SYD) FRANZCO†,‡,§,∥; Grigg, John MBBS (QLD) MD (SYD) FRANZCO FRACS¶,#,**,††

doi: 10.1097/IJG.0b013e31829d9be2
Original Studies
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Purpose: To evaluate outcomes of pars plana (PP) versus anterior chamber (AC) placement of Baerveldt glaucoma drainage device (GDD).

Methods: This study is a nonrandomized, retrospective case series evaluating 63 eyes that underwent GDD insertion with Baerveldt 350 device under the supervision of 2 surgeons at 5 centers. The drainage tube was either inserted into the AC or through the PP into the vitreous cavity where eyes had been vitrectomized. Surgery was conducted between 2003 and 2010 with minimum patient follow-up of 6 months. Data on postoperative intraocular pressure (IOP), visual acuity, number of hypotensive medications, and surgical complications were recorded.

Results: Of the 63 drainage device surgeries, 34 tubes were placed in the AC and 29 were placed into the posterior segment through the PP. Preoperative mean IOP was 32.3±20.3 mm Hg in the AC group and 32.8±18.4 mm Hg in the PP group. Postoperative mean IOP was reduced at all follow-up time points in both the groups. Postoperative mean IOP in the anterior tube group was 14.0, 12.9, and 14.0 mm Hg and in the PP group was 14.2, 14.2, and 14.0 mm Hg, at the 1-, 2-, and 3-year follow-up, respectively. The qualified success rate at 2 years was 94% for the PP group and 91% for the AC group, whereas absolute success was 35% for the PP group and 27% for the AC group at 2-year follow-up.

Conclusions: Insertion of the tube of the Baerveldt GDD into the PP is a safe and effective method for IOP control in aphakic, pseudophakic, and vitrectomized eyes where there is a need to avoid anterior tube placement such as coexisting corneal pathology. IOP control results appear comparable to conventional AC placement.

*University of Sydney

Central Clinical School

††Sydney Medical School, The University of Sydney

Australian School of Advanced Medicine, Macquarie University

§Concord Hospital

Liverpool Hospital

Department of Ophthalmology, Save Sight Institute, Sydney Eye Hospital Campus

#Sydney Eye Hospital

**The Children’s Hospital Westmead, Sydney, Australia

Disclosure: The authors declare no conflict of interest.

Reprints: Anthony Rososinski, MBBS (SYD) MBA, University of Sydney, 7/297 Edgecliff Road, Woollahra, NSW, Australia 2025 (e-mail: aros7415@uni.sydney.edu.au).

Received July 12, 2012

Accepted April 14, 2013

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