In patients with severe optic nerve damage, it is crucial to prevent the hypertensive phase that can develop after Baerveldt
glaucoma drainage implant (BGI) surgery. We describe the combination of BGI surgery with surgical
bleb revision to prevent the postoperative hypertensive phase.
CASE REPORTS: We report two patients who underwent BGI surgery combined with surgical
bleb revision. The combined surgery was performed in a 62-year-old man with
open-angle glaucoma (patient 1) and a 37-year-old man with
neovascular glaucoma (patient 2) at Asahikawa Medical University in 2013. Each patient had undergone a previous failed
trabeculectomy and another
trabeculectomy was expected to be unsuccessful. In patient 1, the early postoperative intraocular pressure (IOP) was well controlled due to a well-functioning
bleb, despite development of a small amount of
hyphema. In contrast, in patient 2 the postoperative IOP was higher with poor
bleb formation; however, after
bleb needling, the IOP was well controlled. Thus, the usual techniques used after
trabeculectomy were also applicable in this combined surgery. For comparison, we also report the case of a 54-year-old woman with secondary
glaucoma who underwent BGI surgery alone (patient 3). The postoperative IOP remained relatively high compared to patients 1 and 2.
CONCLUSION: