A Retrospective Comparison of Primary Baerveldt Implantation versus Trabeculectomy with Mitomycin C.
Panarelli Joseph F, Banitt Michael R, Gedde Steven J, Shi Wei, Schiffman Joyce C, Feuer William J
AI Summary
This study found Baerveldt implantation and trabeculectomy with MMC had similar success and complication rates for primary glaucoma surgery, offering both as viable options.
Abstract
Purpose
To compare the safety and efficacy of Baerveldt implantation (Abbott Medical Optics, Santa Ana, CA) and trabeculectomy with mitomycin C (MMC) in patients who have not undergone prior incisional ocular surgery.
Design
Retrospective, comparative case series.
Participants
A total of 125 patients with low-risk glaucoma undergoing primary glaucoma surgery, including 55 patients who received a 350-mm(2) Baerveldt glaucoma implant and 70 patients who underwent trabeculectomy with MMC.
Methods
Eligible patients were identified using Current Procedural Terminology codes, and their medical records were reviewed retrospectively.
Main outcome measures
The primary outcome measure was surgical success (intraocular pressure [IOP] ≤21 mmHg and reduced ≥20% from baseline, IOP >5 mmHg, no reoperation for glaucoma, no loss of light-perception vision). Secondary outcome measures included visual acuity, IOP, number of glaucoma medications, and complications.
Results
The cumulative probability of success at 3 years with or without medical therapy was 87% in the Baerveldt group and 76% in the trabeculectomy group (P = 0.23). Postoperative complications occurred in 11 patients (20%) in the Baerveldt group and 20 patients (29%) in the trabeculectomy group (P = 0.27). Mean follow-up ± standard deviation was 27±19 months in the Baerveldt group and 34±20 months in the trabeculectomy group (P = 0.053).
Conclusions
Similar rates of surgical success and postoperative complications were observed in patients undergoing trabeculectomy with MMC and in those undergoing Baerveldt implantation during 3 years of follow-up. Both are viable primary glaucoma procedures in patients who have not undergone prior ocular surgery.
MeSH Terms
Shields Classification
Key Concepts4
The cumulative probability of success at 3 years with or without medical therapy was 87% in the Baerveldt glaucoma implant group (n=55 patients) and 76% in the trabeculectomy with mitomycin C group (n=70 patients) in patients with low-risk glaucoma undergoing primary glaucoma surgery (P = 0.23).
Postoperative complications occurred in 11 patients (20%) in the Baerveldt glaucoma implant group (n=55 patients) and 20 patients (29%) in the trabeculectomy with mitomycin C group (n=70 patients) in patients with low-risk glaucoma undergoing primary glaucoma surgery (P = 0.27).
Similar rates of surgical success and postoperative complications were observed in patients undergoing trabeculectomy with mitomycin C and in those undergoing Baerveldt implantation during 3 years of follow-up in patients with low-risk glaucoma who had not undergone prior ocular surgery.
Both Baerveldt implantation and trabeculectomy with mitomycin C are viable primary glaucoma procedures in patients who have not undergone prior ocular surgery.
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