Outcomes of Baerveldt Glaucoma Drainage Devices in Pediatric Eyes

Jacobson, Adam; Besirli, Cagri G.; Bohnsack, Brenda L.

doi:10.1097/ijg.0000000000001970

Cited by 12 publications

(28 citation statements)

References 53 publications

(260 reference statements)

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“…Thus, despite the fact that trabeculectomies are generally able to achieve lower eye pressures, GDDs have become the mainstay of angle-bypass surgery in children. [82][83][84][85][86][87][88][89][90]…”

Section: Glaucoma In Arsmentioning

confidence: 99%

“…Non-valved GDDs, such as Baerveldt and Molteno implants, require either a dissolvable ligature suture or implantation in two steps as the resistance to aqueous outflow is dependent on the formation of a capsule around the GDD plate. 88 The pressure lowering effect should be delayed for at least 3 weeks, but hypotony can still be a challenge. 88,95 However, the absence of early aqueous humor outflow in non-valved implants is thought to limit plate encapsulation and ultimately increase success and survival time compared to valved GDDs.…”

mentioning

confidence: 99%

“…88 The pressure lowering effect should be delayed for at least 3 weeks, but hypotony can still be a challenge. 88,95 However, the absence of early aqueous humor outflow in non-valved implants is thought to limit plate encapsulation and ultimately increase success and survival time compared to valved GDDs.…”

mentioning

confidence: 99%

“…[96][97][98] Ciliary body ablation, either transscleral or endoscopic, can help control IOP, but is most effective after aqueous outflow has been established with a GDD. 10,88,99 In severe anterior segment dysgenesis, transscleral cycloablation can seem like an attractive option given the challenges and potential complications of intraocular surgery in these complex eyes. However, the window between glaucoma and hypotony is slim if there is no adequate outflow.…”

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confidence: 99%

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Ophthalmological Manifestations of Axenfeld-Rieger Syndrome: Current Perspectives

Michels¹,

Bohnsack²

2023

OPTH

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Axenfeld-Rieger syndrome (ARS) is a rare congenital disease that is primarily characterized by ocular anterior segment anomalies but is also associated with craniofacial, dental, cardiac, and neurologic abnormalities. Over half of cases are linked with autosomal dominant mutations in either FOXC1 or PITX2, which reflects the molecular role of these genes in regulating neural crest cell contributions to the eye, face, and heart. Within the eye, ARS is classically defined as the combination of posterior embryotoxon with iris bridging strands (Axenfeld anomaly) and iris hypoplasia causing corectopia and pseudopolycoria (Rieger anomaly). Glaucoma due to iridogoniodysgenesis is the main source of morbidity and is typically diagnosed during infancy or childhood in over half of affected individuals. Angle bypass surgery, such as glaucoma drainage devices and trabeculectomies, is often needed to obtain intraocular pressure control. A multi-disciplinary approach including glaucoma specialists and pediatric ophthalmologists produces optimal outcomes as vision is dependent on many factors including glaucoma, refractive error, amblyopia and strabismus. Further, since ophthalmologists often make the diagnosis, it is important to refer patients with ARS to other specialists including dentistry, cardiology, and neurology.

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Section: Glaucoma In Arsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Ophthalmological Manifestations of Axenfeld-Rieger Syndrome: Current Perspectives

Michels¹,

Bohnsack²

2023

OPTH

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“…Initially, this implant showed an excellent success rate, but it is seen that its rate of survival decreases with time. In most cases, this requires numerous surgeries so that IOP can be maintained and vision can be preserved [ 23 ]. The BGDD is suitable for treating high intraocular pressure due to refractory glaucoma.…”

Section: Reviewmentioning

confidence: 99%

A Review on Glaucoma Drainage Devices and its Complications

Gupta¹,

Jeria²

2022

Cureus

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Glaucoma is one of the leading causes of blindness in the world. It is an ocular disorder that may have multiple etiologies and which can present as optic neuropathy and increased intraocular pressure (IOP), but in some cases like normotensive glaucoma, the IOP may remain normal. Its gradually progressive nature makes it important for early diagnosis; although the loss of vision is slow, lost vision can't be restored. Glaucoma drainage implant surgeries are an increasingly popular option in recent days in complicated cases of glaucoma where the previous trabeculectomy had failed and medical management was not responsive. Glaucoma drainage devices (GDD) are of various designs; they are implanted according to the patient condition and surgeons' preference. There are complications after the implantation of a GDD like hypotony, endophthalmitis, migration of the plate, extrusion, erosion of the mucous membrane, etc. In the market, there are various drainage devices present, but some of them are frequently used and popular.In this article, we will discuss some most commonly used GDDs and their complications. Among these, four are the most popular: Molteno, Baerveldt, Krupin, and Ahmed. The failure rate of the GDD is low. In many studies, it has been noted that only half of the GDD remains functional after five years. Therefore, further studies are still being conducted to refine the biomaterials, techniques, and shape of the GDD. The technique of surgery is also very much crucial in the success of GDD implantation. The glaucoma type is an essential factor in deciding the treatment, and the outcome of the surgery also depends on it.

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