Combined Baerveldt Glaucoma Implant And Scleral Buckling Surgery For Patients With Retinal Detachment And Coexisting Glaucoma

Purpose: To report on the usefulness of combined Baerveldt glaucoma implantation (BGI) and scleral buckling surgery for patients with glaucoma requiring a scleral buckle for retinal detachment repair.Methods: Retrospective, consecutive, noncomparative, and interventional case series of 30 eyes (30 patients) that underwent simultaneous scleral buckle and BGI surgery, using a staged (group 1, n=21 patients) or nonstaged (group 2, n=9 patients) approach to BGI implantation. Successful intraocular pressure (IOP) control was defined as 6mm Hg <= IOP <= 18mm Hg.Results: Although not statistically significant, mean best corrected visual acuity (LogMAR) improved from 2.0 before surgery to 1.7 after surgery (P=0.13) with a mean follow-up of 27.7 months. Of the 21 patients in group 1, only 13 (62%) required second-stage tube insertion at a mean of 7.0 +/- 8.0 months (range, 1 to 24 mo) postoperatively. For these eyes combined with group 2 eyes, mean IOP was reduced from 31.1 +/- 10.8 to 12.7 +/- 6.0mm Hg (P< 0.0001), and the mean number of glaucoma medications was reduced from 2.9 +/- 1.4 to 1.2 +/- 1.3 (P<0.001). Life table rates of successful IOP control were 90% and 80% at 12 and 24 months, respectively.Conclusions: Combined scleral buckle and BGI is an effective technique for managing coexisting glaucoma and retinal detachment and provides the clinician with a useful surgical option while minimizing surgical risk.