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Journal of Ophthalmology
Volume 2017, Article ID 4140305, 12 pages
Research Article

Vision Loss and Recovery after Baerveldt Aqueous Tube Shunt Implantation

1University of Southern California Eye Institute, Department of Ophthalmology, Keck School of Medicine, The University of Southern California, Los Angeles, CA, USA
2Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
3Doheny Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
4Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
5Department of Ophthalmology and Visual Sciences, Case Western Medical Center, Cleveland, OH, USA

Correspondence should be addressed to Brian Francis; gro.ynehod@sicnarfb

Received 21 August 2016; Revised 18 December 2016; Accepted 28 December 2016; Published 18 January 2017

Academic Editor: Majid M. Moshirfar

Copyright © 2017 Esther Lee Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study aims to determine the course of vision loss after Baerveldt aqueous tube shunt placement and identify risk factors associated with unexplained severe long-term vision loss, or snuff-out. We retrospectively reviewed 247 eyes of 222 patients who underwent Baerveldt implantations at one of two academic institutions. Postoperative vision loss at 6 months following surgery was categorized as mild-to-moderate versus severe and long-term versus transient. Long-term vision loss, defined as 3 or more lines of Snellen visual acuity (VA) loss compared with preoperative VA, occurred in 63 of 247 eyes (25.5%), and 39 had mild-to-moderate and 24 had severe loss. Of these 63 eyes, 18 had no identifiable cause of vision loss. On multivariate analysis, poorer Snellen VA on postoperative day 1 (POD1) was found to be a significant risk factor for long-term vision loss (). In addition, the negative change in preoperative versus POD1 Snellen VA () and the presence of split fixation involving the inferonasal quadrant on preoperative Humphrey visual field () were significant risk factors for snuff-out. Transient vision loss occurred in 76 of 242 eyes (30.8%). In conclusion, vision loss is not uncommon after Baerveldt surgery, with snuff-out occurring in 2.4% of cases in this study.