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Combined Baerveldt glaucoma drainage implant surgery and surgical bleb revision for preventing a postoperative hypertensive phase

Authors Kawai M, Yamaguchi T, Nakabayashi S, Yoshida A

Received 25 January 2014

Accepted for publication 11 February 2014

Published 16 April 2014 Volume 2014:8 Pages 773—776


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Motofumi Kawai, Toru Yamaguchi, Seigo Nakabayashi, Akitoshi Yoshida

Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan

Background: In patients with severe optic nerve damage, it is crucial to prevent the hypertensive phase that can develop after Baerveldt glaucoma drainage implant (BGI) surgery. We describe the combination of BGI surgery with surgical bleb revision to prevent the postoperative hypertensive phase.
Case reports: We report two patients who underwent BGI surgery combined with surgical bleb revision. The combined surgery was performed in a 62-year-old man with open-angle glaucoma (patient 1) and a 37-year-old man with neovascular glaucoma (patient 2) at Asahikawa Medical University in 2013. Each patient had undergone a previous failed trabeculectomy and another trabeculectomy was expected to be unsuccessful. In patient 1, the early postoperative intraocular pressure (IOP) was well controlled due to a well-functioning bleb, despite development of a small amount of hyphema. In contrast, in patient 2 the postoperative IOP was higher with poor bleb formation; however, after bleb needling, the IOP was well controlled. Thus, the usual techniques used after trabeculectomy were also applicable in this combined surgery. For comparison, we also report the case of a 54-year-old woman with secondary glaucoma who underwent BGI surgery alone (patient 3). The postoperative IOP remained relatively high compared to patients 1 and 2.
Conclusion: Combining BGI surgery with surgical bleb revision might be effective to prevent the hypertensive phase that can occur after BGI surgery.

Keywords: Baerveldt glaucoma drainage implant, surgical bleb revision, intraocular pressure

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