PURPOSE: To report the clinical outcome in 48 eyes of 48 children who received a Baerveldt glaucoma implant (BGI) for themanagement of pediatric glaucoma. DESIGN: Retrospective, noncomparative case series. METHODS: The medical records of all patientswith pediatric glaucomawho underwent a BGI at two tertiary care referral centers in LosAngeles between 1990 and 1999 were reviewed. Intraocular pressure (IOP)-, intraoperative and postoperative complications, number of glaucoma medications, visual acuity, and pre-and postoperative corneal diameter and axial length were collected from patient records. Criteria for success were IOPbetween 6 and 21 mmHg with or without glaucoma medications, no need for further glaucoma surgery,the absence of visually threatening complications, and some residual vision (minimum visual acuity of light perception). RESULTS: The study included 48 eyes from 48 patients aged 16 years and younger (mean age 4.1 years). Mean preoperative IOP was 31.2±25.7 mm Hg, and mean postoperative IOP was 16.4±4.9 mm Hg. Cumulative probability of success (based on the Kaplan-Meier survival curve) was 95%at 6 months, 90%at 1 year, 84%at 2 years, 74%at 36 months, and 58%at 48 months. On average, the BGIs were successful for a mean period of 5.6 years (67.7 months). Overall, 11 eyes failed, with the causes being uncontrolled IOP(eight eyes), retinal detachment (two eyes), and no light perception (one eye). CONCLUSIONS: Baerveldt glaucoma implants can be a safe and effective treatment modality for the management of pediatric glaucoma refractive to medical therapy.
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