Pars plana vitrectomy and Baerveldt glaucoma implant in the treatment of refractory glaucoma

AIM: To investigate the clinical efficacy of pars plana vitrectomy and Baerveldt glaucoma implant(PPV-BGI)in the treatment of refractory glaucoma. METHODS: One hundred twenty-nine refractory glaucoma patient's clinical data from March 2013 to December 2015 that underwent PPV -BGI were retrospectively reviewed. Among them, 63 eyes were neovascular glaucoma(NVG)and 69 eyes were other types of glaucoma(non-NVG). The changes of intraocular pressure(IOP), surgical results, visual acuity(VA), the number of glaucoma medications, complications, and the success rate of surgery were analyzed. RESULTS: Cumulative success rates for the NVG group and non-NVG group were 46.0% and 81.2%, respectively, within 1a after surgeries, the difference was significantly(P<0.05). Preoperative IOP was 30.4±10.2mmHg in the non-NVG group and 40.1±10.4mmHg in the NVG group, and IOP was reduced to 14.9±4.1mmHg in the non-NVG group and 17.8±4.9mmHg in the NVG, and the difference was significantly(P<0.05). Number of glaucoma medications decreased from 2.7±1.2 in the non-NVG group and 2.9±1.4 in the NVG group preoperatively to 0.51±0.96 in the non-NVG group and 0.96±1.18 in the NVG group, and the difference was significantly(P<0.05). Improvement in VA of in the NVG group and non-NVG group were observed in 14 eyes of 13 patients and 38 eyes and 37 patients respectively, and the difference was significantly(P<0.05). The postoperative complications of 1d and 1a follow-up in NVG group was significantly higher than non-NVG group(P<0.05). CONCLUSION: PPV-BGI is a viable surgical option for eyes with refractory glaucoma, but visual outcomes are frequently poor because of ocular comorbidities, especially in eyes with NVG.