Simultaneous placement of 2 glaucoma drainage devices for uncontrolled glaucoma

Abstract

Objective: To report baseline characteristics and surgical outcomes of placement of simultaneous glaucoma drainage devices (GDDs) in eyes with considerably elevated intraocular pressure (IOP) despite maximal medical therapy.

Design: Retrospective case series.

Participants: Twelve eyes of 12 patients underwent simultaneous placement of a Baerveldt 350 GDD and an Ahmed S3 GDD in the same eye.

Methods: The medical records were reviewed of consecutive patients who underwent simultaneous placement of a Baerveldt 350 GDD and an Ahmed S3 GDD in the same eye at the University of Michigan Kellogg Eye Center from 2006 to 2009. Baseline characteristics, preoperative and postoperative IOP, number of glaucoma medications, visual acuity, and complications were recorded.

Results: Mean follow-up time was 28.6 ± 22.8 months. The mean baseline cup/disc ratio was recorded at 0.94 ± 0.07 horizontally and 0.92 ± 0.09 vertically. The mean baseline IOP of 38.8 ± 6.2 mm Hg was significantly reduced at all time points postoperatively, and the mean IOP at last follow-up was 15.1 ± 4.9 mm Hg (p ≤ 0.0001). Mean number of glaucoma medications was significantly lower at last follow-up than preoperatively (1.4 ± 1.3 vs 3.2 ± 0.8; p = 0.001). There was no difference in mean logMAR visual acuity from before surgery to last follow-up (1.14 vs 1.12; p = 0.933).

Conclusions: Simultaneous placement of 2 GDDs effectively reduces IOP in the immediate postoperative period and long-term, and may be useful in glaucomatous eyes with advanced disease and considerably elevated preoperative IOP.