Patients with glaucoma who underwent Baerveldt implantation by residents experienced similar outcomes and IOP reduction 1 year postoperatively when compared with implantations performed by glaucoma specialists, according to a study.
“When compared with outcomes by glaucoma specialists in several landmark prospective studies, residents achieved comparable reductions in IOP and failure rates during the year following surgery,” the study authors wrote.
Researchers compared the 1-year outcomes of Baerveldt 350 (Johnson & Johnson Vision) glaucoma drainage device implantation in veterans by residents at the Durham Veterans Affairs Medical Center from July 1, 2007, to June 30, 2017, and 1-year outcomes of the same device implanted by glaucoma specialists in several prospective studies. Forty-eight eyes were operated on by residents, and they had a baseline mean IOP of 23.1 mm Hg and were on a mean 3.7 medications.
Failure was defined as two consecutive patients visits, starting at postoperative month 3, with IOP of 5 mm Hg or less, IOP of 21 mm Hg or higher, or less than 20% IOP reduction from baseline. Reoperation for glaucoma and loss of light perception were also considered failures.
In the procedures performed by residents, at postoperative day 1, the mean IOP was 20.5 mm Hg with no medications. By postoperative week 1, the mean IOP was 14.3 mm Hg with a mean of 1.9 medications; postoperative month 1, mean IOP was 16.7 mm Hg with a mean of 2.2 medications; postoperative month 3, mean IOP was 15.1 mm Hg with a mean of 2.1 medications; postoperative month 6, mean IOP was 12.8 mm Hg with a mean of 2.8 medications; and postoperative 1 year, mean IOP was 13 mm Hg with a mean of 2.8 medications.
Other than day 1 postoperative, the mean IOP decreased at all time intervals (P < .01); medication use was reduced at all time points (P < .01).
At 1 year, eight patients were defined as treatment failures, seven due to elevated IOP and one due to dehiscence requiring closure. No patients underwent further glaucoma surgery or lost light perception. – by Robert Linnehan
Disclosures: The authors report no relevant financial disclosures.