Roy S, Ravinet E, Mermoud A
Hĵpital Ophtalmique Jules Gonin, University of Lausanne, Switzerland.
Int Ophthalmol. 2001;24(2):93-100. doi: 10.1023/a:1016335313035.
To evaluate the clinical outcome of patients who received a Baerveldt implant for refractory glaucoma and to identify factors which may influence the outcome.
Retrospective study including 51 eyes of 51 patients with medically uncontrolled glaucoma who underwent Baerveldt implant surgery between June 1994 and December 1998. Criteria for success were intraocular pressure (IOP) < or = 21 mmHg and > 6 mmHg, necessity of further antiglaucoma medications, absence of additional glaucoma surgery and no loss of light perception.
Over a mean follow-up of 37.6 (SD: +/-18.8) months, the mean intraocular pressure decreased from 34.8 (+/-12.5) mmHg to 14.0 (+/-4.3) mmHg at month 60. Qualified success rate, achieved when IOP was below 21 mmHg and higher than 6 mmHg with medications was 25/48 (52%), complete success rate (same IOP limits without medication) was 14/48 (29%). Seven eyes had major complications or lost light perception. Postoperative visual acuity improved or remained within one Snellen line of the preoperative visual acuity in 35 patients (73%). Factors associated with a better prognosis were a preoperative visual acuity better than 20/400 and etiology of glaucoma.
The Baerveldt implant is effective in lowering intraocular pressure in most patients with refractory glaucoma. Long-term results are promising with satisfactory IOP control.
评估接受Baerveldt植入物治疗难治性青光眼患者的临床结局，并确定可能影响结局的因素。
回顾性研究纳入了1994年6月至1998年12月期间51例药物治疗无法控制的青光眼患者的51只眼，这些患者接受了Baerveldt植入物手术。成功标准为眼压（IOP）≤21 mmHg且＞6 mmHg，无需进一步使用抗青光眼药物，未进行额外的青光眼手术且无光感丧失。
平均随访37.6（标准差：±18.8）个月，在第60个月时，平均眼压从34.8（±12.5）mmHg降至14.0（±4.3）mmHg。当眼压低于21 mmHg且使用药物后高于6 mmHg时达到的合格成功率为25/48（52%），完全成功率（相同眼压范围且无需用药）为14/48（29%）。7只眼出现了严重并发症或无光感。35例患者（73%）术后视力提高或保持在术前视力的一个Snellen视力表行以内。与较好预后相关的因素是术前视力优于20/400以及青光眼的病因。
Baerveldt植入物对大多数难治性青光眼患者降低眼压有效。长期结果令人满意，眼压控制良好。
