A Retrospective Comparison of Primary Baerveldt Implantation versus Trabeculectomy with Mitomycin C

作者：Panarelli Joseph F; Banitt Michael R; Gedde Steven J^*; Shi Wei; Schiffman Joyce C; Feuer William J

来源：Ophthalmology, 2016, 123(4): 789-795.

DOI：10.1016/j.ophtha.2015.11.017

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.

• 出版日期2016-4