Risk factors for exposure of Baerveldt glaucoma drainage implants: a case-control study
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RESEARCH ARTICLE
Open Access
Risk factors for exposure of Baerveldt glaucoma drainage implants: a case-control study Ayaka Edo* , Koji Jian and Yoshiaki Kiuchi
Abstract Background: Glaucoma drainage implant exposure is one of the serious complications after glaucoma drainage implant surgery. The purpose of this study is to evaluate the risk factors for exposure of the device after implantation of a Baerveldt glaucoma drainage implant. Methods: This is a retrospective review of the medical records of all patients who underwent Baerveldt glaucoma drainage implant surgery at the Hiroshima University Hospital between April 1, 2012 and October 31, 2016, and who were followed for at least 6 months after surgery. We examined the risk factors for implant exposure based on data obtained from the medical records, with a particular focus on the differences in implant models. Results: A total of 80 eyes from 80 patients were identified; all patients were Japanese. In this study, the rate of Baerveldt glaucoma drainage implant exposure was 15.0% (12 of 80 eyes). The exposure rate for the BG 102-350 tended to be higher than that for the BG 101-350 and BG 103-250 (p = 0.092; adjusted odds ratio = 3.34; 95% confidence interval, 0.82–13.58). In the patients who had diabetic mellitus, the BG 102-350 showed a significant risk of implant exposure (p = 0.038; adjusted odds ratio = 15.36; 95% confidence interval, 1.17–202.59). Conclusions: In Baerveldt glaucoma drainage implant surgery in patients with diabetes, using the BG 102-350 was associated with greater risk of implant exposure compared with using the BG 101-350 or BG 103-250. Keywords: Glaucoma drainage device exposure, Baerveldt glaucoma drainage implant, Risk factor, Implant model
Background Reducing intraocular pressure (IOP) is a common method for suppressing the progression of glaucoma [1, 2]. If the condition cannot be controlled with eye drops, glaucoma surgery is required. One traditional form of glaucoma surgery is the trabeculectomy (TLE). Recently, glaucoma drainage device (GDD) implantation has become a popular glaucoma operation [3, 4]. A GDD is a filtration system consisting of a silicon tube and a plate. The tube is inserted into the eye, and the plate is fixed * Correspondence: [email protected] Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
subconjunctivally. The aqueous humor is allowed to flow out of the eye through the tube and into the plate, and is absorbed into the surrounding tissue to reduce the IOP [2, 4]. The Baerveldt glaucoma drainage implant (BGI, Johnson & Johnson Vision, Santa Ana, CA, USA) is one of the most popular types of GDD [2, 5, 6]. GDD implantation can provide long-term IOP control that is at least as efficacious as TLE for glaucoma treatment [7, 8]. However, there are different complications between GDD implantation and TLE. GDD implantation has complications such as implant exposure, tube obstruction, diplopia an
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