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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.07.03 Baerveldt glaucoma implants in the inferior quadrants of the eye Dietlein T. S., Jordan J. F., Lüke C., Dinslage S., Krieglstein G. K.
Zentrum für Augenheilkunde, Universität Köln Objective: Glaucoma implants should be inserted in the supero-temporal quadrant whenever possible. However, extreme conjunctival scarring can cause problems leading the surgeon to implantation in the inferior quadrants. The aim of our study was to evaluate the clincal efficacy and complications of Baerveldt implants in the inferior quadrants.
Methods: We analysed the one-year follow-up of 10 patients with refractory glaucoma (open-angle, aphakic, secondary glaucoma with ICE) that had received Baerveldt implants in the infero-temporal or infero-nasal quadrant. Each eye had already undergone between 2 and 8 antiglaucomatous or other intraocular interventions. The mean preop. IOP was 31 mmHg despite max. antiglaucomatous therapy.
Results: Although the majority of eyes received topical glaucoma medication after one year, only one eye had to undergo glaucoma surgery once again. Despite IOP control a drop of central visual acuity occured in 3 eyes during follow-up. Re-surgery had to be done in one eye with implant dislocation and in one eye with conjunctival arrosion around the tube. One implant showed slight anterior migration without arrosion requiring no surgical intervention.
Conclusions: In cases of extremely limited prognosis of any glaucoma surgery Baerveldt implantats in the inferior quadrants can effectively reduce the IOP, if the upper quadrants show massive conjunctival scarring. However, implant extrusion and implant arrosion as well as deterioration of central vision have to be faced as possible complications.
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