Use of a 350‐mm2 Baerveldt glaucoma drainage device to maintain vision and control intraocular pressure in dogs with glaucoma: a retrospective study (2013–2016). (16th November 2016)

• Record Type: Journal Article
• Authors: Graham, Kathleen L.; Donaldson, David; Billson, Francis A.; Billson, F. Mark
• Is Part Of: Veterinary ophthalmology. Volume 20:Number 5(2017)
• Page Start: 427
• Page End: 434
• Publication Date: 2016-11-16
• Subjects: Baerveldt -- canine -- dog -- glaucoma drainage device -- glaucoma surgery -- gonioimplant; Veterinary ophthalmology -- Periodicals; 636.08977
• DOI: 10.1111/vop.12443
• Languages: English
• ISSNs: 1463-5216

Abstract

Abstract: Objective: To evaluate the 350‐mm 2 Baerveldt glaucoma drainage device (GDD) in dogs with refractory glaucoma when modifications to address postoperative hypotony (extraluminal ligature; intraluminal stent) and the fibroproliferative response (intraoperative Mitomycin‐C; postoperative oral colchicine and prednisolone) are implemented as reported in human ophthalmology. Design: Retrospective case series. Animals: Twenty‐eight client‐owned dogs (32 eyes) including seven dogs (nine eyes) with primary glaucoma and 21 dogs (23 eyes) with secondary glaucoma. Methods: The medical records of all dogs undergoing placement of a 350‐mm 2 Baerveldt GDD at a veterinary ophthalmology referral service between 2013 and 2016 were reviewed. Signalment, diagnosis, duration and previous treatment of glaucoma, previous intraocular surgery, IOP, visual, and surgical outcomes were recorded. Results: IOP was maintained <20mmHg in 24 of 32 (75.0%) eyes. Fourteen eyes (43.8%) required no adjunctive treatments to maintain this IOP control. Fewer doses of glaucoma medication were required following surgery. Vision was retained in 18 of 27 (66.7%) eyes with vision at the time of surgery. No eyes that were blind at the time of surgery ( n = 5) had restoration of functional vision. Complications following surgery included hypotony (26/32; 81.3%), intraocular hypertension (24/32; 75.0%), and fibrin formation within the anterior chamber (20/32; 62.5%). The average follow‐up after placement of the GDD was 361.1 days (median 395.6 days). Conclusion: Efforts to minimize postoperative hypotony and address the fibroproliferative response following placement of a 350‐mm 2 Baerveldt GDD showed an increased success rate to other reports of this device in dogs and offers an alternative surgical treatment for controlling intraocular pressure in dogs with glaucoma.