Factors associated with the surgical outcomes of Baerveldt glaucoma implant for open-angle glaucoma, an age-related eye disease

Iraha, Satoshi; Takihara, Yuji; Urahashi, Yui; Watanabe, Tetsu; Nakamura, Kenichi; Urahashi, Mai; Watanabe-Kitamura, Fumika; Nakashima, Kenichiro; Takahashi, Eri; Kojima, Sachi; Tanihara, Hidenobu; Inoue, Toshihiro

doi:10.1038/s41598-021-04570-4

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…It might be difficult to control an IOP ≤ 17 mmHg in eyes that have been subjected to prior intraocular surgeries. Moreover, younger age was linked to an increased risk of surgical failure for criterion B and C. Previous reports also suggested that younger age was a risk factor for failure of BGI surgery 7,8,13 . As previously mentioned, the wound healing process by active fibroblasts may be associated with surgical failure of BGI.…”

Section: Discussionmentioning

confidence: 91%

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Long-term outcomes of Baerveldt glaucoma implant surgery in Japanese patients

Iwasaki,

Komori,

Arimura

et al. 2023

Sci Rep

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This study evaluated the long-term surgical outcomes of Baerveldt glaucoma implant (BGI) surgery in patients with refractory glaucoma (204 eyes/204 patients). Surgical failure was defined by: < 20% reduction in preoperative intraocular pressure (IOP), or criterion A (IOP > 21 mmHg), criterion B (IOP > 17 mmHg), or criterion C (IOP > 14 mmHg). Reoperation, loss of light perception vision, or hypotony also denoted failure. The probability of success at 5 years postoperatively using criteria A, B, and C was 72.4%, 49.7%, and 24.4%, respectively. The mean IOP decreased significantly from 32.7 ± 9.7 mmHg preoperatively to 13.1 ± 3.9 mmHg at 5 years; the mean number of glaucoma medications also decreased from 3.7 ± 1.2 to 1.8 ± 1.9 (both P < 0.01). The number of previous intraocular surgeries was significantly associated with failure in the multivariable analysis for criterion B (hazard ratio 1.30; P < 0.01) and criterion C (hazard ratio 1.19; P = 0.031). Early and late postoperative complications occurred in 82 (40.2%) and 28 (13.7%) eyes, respectively. Postoperative interventions were performed in 44 eyes (21.6%). BGI surgery resulted in significant long-term decreases in IOP and the number of glaucoma medications. BGI surgery is effective for refractory glaucoma. However, postoperative interventions due to complications are required in numerous cases.

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Section: Discussionmentioning

confidence: 91%

“…9 . Other studies with small sample sizes reported the surgical results of BGI separately for each type of glaucoma [10][11][12][13][14][15] . The present study is unique because it examined 204 eyes of Japanese patients with different types of glaucoma and evaluated the long-term surgical outcome of BGI (350-mm 2 endplate) surgery.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of Baerveldt glaucoma implant surgery in Japanese patients

Iwasaki,

Komori,

Arimura

et al. 2023

Sci Rep

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“…Younger age increased the risk of surgical failure for all criteria in our study, which is consistent with the ndings of previous studies on tube-shunt surgery. 17,[24][25][26][27] Age-related impairments in wound healing have been associated with broblast dysfunction, whereas younger age has been associated with a more robust wound healing response. [28][29][30] The wound healing process involving active broblasts may play a role in the surgical failure of ltering surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of Baerveldt glaucoma implant versus Ahmed glaucoma valve in neovascular glaucoma: A multicenter study

Iwasaki,

Kojima,

Wajima

et al. 2024

Preprint

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This multicenter retrospective study compared the surgical outcomes of Baerveldt glaucoma implant (BGI) surgery with those of Ahmed glaucoma valve (AGV) surgery in patients with neovascular glaucoma (NVG). This study included patients with NVG aged ≥ 20 years who had undergone BGI (223 eyes) or AGV (146 eyes) surgery between April 1, 2012, and December 31, 2021, across 10 clinical centers in Japan. Surgical success or failure was the primary outcome measure of this study. We defined surgical failure as a reduction of < 20% in the pre-operative intraocular pressure (IOP) or criterion A (IOP > 21 mmHg), criterion B (IOP > 17 mmHg), or criterion C (IOP > 14 mmHg). In addition, we considered a requirement for reoperation, loss of light perception, and hypotony as surgical failure. The surgical success rate of the BGI surgery group was significantly higher than that of the AGV group for criteria A (P = 0.01) and B (P = 0.01). Multivariate analysis revealed that AGV surgery showed significant associations with surgical failure for criteria A (hazard ratio, 1.74), B (hazard ratio, 1.72), and C (hazard ratio, 1.33). The overall incidence of postoperative complications was comparable between the two groups. The requirement for reoperation in the AGV surgery group was significantly higher than that in the BGI surgery group (12.3% vs. 5.8%, P = 0.03). BGI surgery yielded a higher success rate than AGV surgery in patients with NVG for a target IOP of < 21 or < 17 mmHg. No significant differences were observed between the two procedures in terms of the incidence of postoperative complications. Additional glaucoma surgery was required more frequently following AGV surgery.

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“…Our secondary outcomes are to investigate the association between a history of SGTV and postoperative results, as well as to identify postoperative complications. Additionally, we examined the changes in IOPs and medication scores in eyes affected by ATTRv amyloidosis that required LEC at different time points: baseline, 1 year, 3 years, and 5 years after LEC 30 . These alterations were evaluated in response to LEC and subsequent surgical interventions performed to reduce IOP.…”

Section: Methodsmentioning

confidence: 99%

Long-term surgical results of trabeculectomy for secondary glaucoma in Val30Met hereditary transthyretin amyloidosis

Kitahara,

Kakihara,

Mukawa

et al. 2023

Sci Rep

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This study reports the long-term results of trabeculectomy (LEC) for secondary glaucoma in hereditary transthyretin (ATTRv) amyloidosis patients and its correlation with prior vitrectomy. A retrospective case series was conducted involving 31 consecutive eyes of 20 ATTRv amyloidosis patients who underwent LEC between 2007 and 2020. The mean follow-up period was 73.2 ± 37.0 months (range: 20–181 months). Postoperative intraocular pressures (IOPs) were evaluated based on the following criteria: (a) IOP between 6 and 21 mmHg without additional glaucoma surgeries, except for laser suture lysis, (b) IOP between 6 and 15 mmHg without additional glaucoma surgeries, except for laser suture lysis, and (c) IOP between 6 and 21 mmHg without additional glaucoma surgeries, except for needling and laser suture lysis. Kaplan–Meier analysis revealed survival rates after LEC of 0.52 at 36 months, 0.42 at 60 months, and 0.25 at 84 months under criterion (a); 0.49 at 36 months, 0.27 at 60 months, and 0.11 at 84 months under criterion (b); and 0.76 at 36 months, 0.71 at 60 months, and 0.65 at 84 months under criterion (c). Eyes with a history of small gauge transconjunctival vitrectomy (SGTV) exhibited a tendency towards lower survival rates, although no statistically significant difference was observed (log-rank test; p = 0.193 under criterion (a) and p = 0.0553 under criterion (b)). Our findings suggest that LEC and additional needling procedures can provide some control over IOP; however, the overall postoperative outcomes of LEC for ATTRv amyloidosis remain unsatisfactory, even in the era of SGTV with reduced conjunctival scarring.

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Factors associated with the surgical outcomes of Baerveldt glaucoma implant for open-angle glaucoma, an age-related eye disease

Cited by 5 publications

References 32 publications

Long-term outcomes of Baerveldt glaucoma implant surgery in Japanese patients

Long-term outcomes of Baerveldt glaucoma implant surgery in Japanese patients

Surgical outcomes of Baerveldt glaucoma implant versus Ahmed glaucoma valve in neovascular glaucoma: A multicenter study

Long-term surgical results of trabeculectomy for secondary glaucoma in Val30Met hereditary transthyretin amyloidosis

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