Our Summary

This study focused on understanding the long-term outcomes of a specific kind of eye surgery for glaucoma, a condition that damages the optic nerve and can lead to vision loss. The surgery in question, known as a Baerveldt glaucoma implant (BGI), was performed on 27 eyes (from 24 patients) at Osaka University Hospital between 2012 and 2016.

The researchers followed up with these patients for at least 3 years after their surgery. They were particularly interested in the success rate of the surgery and any associated risk factors. They defined failure as the need for additional surgery to reduce intraocular pressure (IOP - the fluid pressure inside the eye), loss of light perception, and high IOP levels at two consecutive follow-up visits.

They found that the success rates 1 year and 3 years after surgery were 81.5% and 77.8% (based on their first definition of failure), and 51.9% and 48.2% (based on their second definition of failure). They also noted that the rates of complications from the surgery were 29.6% early on and 22.2% later.

The researchers identified two important risk factors for failure of the surgery: high IOP levels 2 months after the surgery and the number of previous eye surgeries a patient had undergone. These findings suggest that the more surgeries a patient has had, and the higher their IOP levels are 2 months after BGI surgery, the more likely the surgery is to fail.

In conclusion, the researchers found that the long-term results and complication rates of BGI surgery at their hospital were in line with what has been reported in previous studies. They also found that IOP levels 2 months after surgery and the number of previous eye surgeries were important factors in predicting the success of the surgery.

FAQs

  1. What are the success rates of Baerveldt glaucoma implant (BGI) surgery 3 years after the operation?
  2. What factors can affect the success of BGI surgery according to the study conducted at Osaka University Hospital?
  3. What were the complication rates after BGI surgery for refractory glaucoma in this study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about glaucoma surgery is to closely follow post-operative care instructions, including using prescribed eye drops and attending all follow-up appointments to monitor intraocular pressure and ensure the success of the surgery.

Suitable For

Patients who have refractory glaucoma, meaning their condition has not responded well to other treatments such as medications or laser therapy, are typically recommended for glaucoma surgery such as Baerveldt glaucoma implant (BGI) surgery. This study found that patients who underwent BGI surgery for refractory glaucoma had success rates of 77.8% at 3 years postoperatively. The study also found that patients with higher intraocular pressure (IOP) 2 months after surgery and a higher number of previous eye surgeries were at a higher risk for surgical failure. Therefore, patients with these factors may be recommended for glaucoma surgery to help manage their condition.

Timeline

Before glaucoma surgery:

  1. Patient undergoes a comprehensive eye examination to determine the severity of glaucoma and assess the need for surgery.
  2. Treatment options are discussed with the patient, including the risks and benefits of surgery.
  3. Pre-operative tests are performed to ensure the patient is a suitable candidate for surgery.
  4. Patient meets with the surgeon to discuss the procedure, expectations, and post-operative care.

After glaucoma surgery:

  1. Patient is monitored closely in the immediate post-operative period for any complications or discomfort.
  2. Patient may experience temporary blurred vision, redness, or mild discomfort in the eye.
  3. Patient is prescribed eye drops and medications to prevent infection and reduce inflammation.
  4. Follow-up appointments are scheduled to monitor the eye pressure and assess the success of the surgery.
  5. Long-term follow-up is important to monitor any late complications and ensure the continued efficacy of the surgery.

What to Ask Your Doctor

  1. What is the success rate of Baerveldt glaucoma implant (BGI) surgery in general, and what is the success rate at your specific hospital?
  2. What are the potential risks and complications associated with BGI surgery?
  3. How many previous eye surgeries have the most successful patients typically had before undergoing BGI surgery?
  4. How soon after surgery will I know if the procedure was successful?
  5. What specific factors will you be monitoring to determine the success of the surgery in the long term?
  6. Will I need to make any lifestyle changes or follow a specific post-operative care plan to optimize the success of the surgery?
  7. Are there any additional treatments or procedures that may be needed in conjunction with BGI surgery to manage my glaucoma effectively?
  8. How often will I need to follow up with you after the surgery, and what signs or symptoms should I watch for that may indicate a potential issue with the surgery?
  9. Can you explain the difference between the two definitions of failure (IOP≧22 mmHg vs. IOP≧17 mmHg) and how they may impact my prognosis?
  10. Are there any specific factors in my individual case that may affect the success of BGI surgery for my glaucoma?

Reference

Authors: Matsushita K, Kawashima R, Kawasaki R, Nishida K. Journal: Jpn J Ophthalmol. 2021 Nov;65(6):820-826. doi: 10.1007/s10384-021-00864-2. Epub 2021 Aug 10. PMID: 34374907