Long-term Intraocular Pressure Control and Corneal Graft Survival in Eyes With a Pars Plana Baerveldt Implant and Corneal Transplant

Purpose To investigate long-term intraocular pressure (IOP) control and corneal graft survival in eyes with a valveless Baerveldt glaucoma drainage implant (GDI) through the pars plana (PP) and a penetrating keratoplasty (PK). Methods We reviewed the medical records of 48 patients (51 eyes) who underwent PP placement of a GDI and a PK between July 1996 and June 2006 at the University of Virginia. The GDI was inserted during the same operation as the PK in 26 eyes (51.0%). Glaucoma control was assessed by IOP and the need for further glaucoma medication or surgery. Corneal grafts were assessed for clarity. Results Mean follow-up was 38.4 months. IOP was successfully controlled in 88%, 85%, and 82% of eyes at 12, 24, and 48 months, respectively. Corneal grafts were clear in 89%, 67%, and 41% of eyes at 12, 24, and 48 months, respectively. Corneal graft failure was significantly higher in eyes with an anterior chamber intraocular lens (P≤0.01), and in eyes with a diagnosis of chronic angle closure glaucoma (P=0.04). Conclusions PP insertion of a valveless GDI tube, in eyes with a previous or concurrent PK, is an effective way to control IOP in eyes with medically uncontrolled glaucoma.