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| Paper, year published | Study Design | Patients included in study | Number of eyes/patients & follow-up (f/u) | Major differences in inclusion/exclusion criteria versus the present study | Average vision loss (mean ± SD) | Significant vision loss after Baerveldt implantation | Comments regarding significant vision loss after BVI |
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| Present study | Retrospective study | Medically uncontrolled glaucoma; underwent BVI placement | 247 eyes in 222 patients
Minimum 6- month f/u | (i) Inclusion criteria: baseline VA ≥ count fingers, OAG, CACG, PXE, pigmentary, traumatic, low-tension, juvenile glaucoma
(ii) Exclusion criteria: aphakia, another concurrent surgery, NVG, congenital + uveitic glaucoma | 1.23 ± 3.27 Snellen line decrease in VA from baseline to postoperative month 6 (or 0.16 units ± 0.49 units when converted into logMAR equivalents) | (i) 25.5% had long-term vision loss
(ii) 7.3% had unexplained long-term vision loss
(iii) 2.4% had snuff-out | Risk factors for snuff-out:
(1) decreased visual acuity on postoperative day one versus baseline, (2) preoperative split fixation in the inferonasal quadrant on HVF |
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| The Ahmed Baerveldt Comparison (ABC) studies: 2015 [5], 2014 [6], 2011 [7] | Prospective, multicenter, randomized, controlled trial | Medically uncontrolled glaucoma; randomly assigned to Ahmed or BVI placement | 133 eyes in 133 patients underwent BVI
117 eyes at 1-year f/u
100 eyes at 3-year f/u
87 eyes at 5-year f/u | (i) Required IOP ≥ 18 mmHg; included NVG, uveitic glaucoma
(ii) Excluded cases with prior cyclodestructive procedures, scleral buckle, silicone oil, or aqueous shunt placement in the same eye | Units logMAR Snellen VA decrease from baseline:
0.16 units, or 1.04 (20/219) at baseline to 1.20 (20/317) at 1-year f/u
0.26 ± 0.74 at 3-year f/u
0.43 ± 0.84 at 5-year f/u | % that lost ≥2 Snellen lines VA from baseline:
34% at 1-year f/u (unexplained VA loss in 6 patients, or 5.1%)
30% at 3-year f/u
(unexplained VA loss in 1 or 1.0%)
44% at 5-year f/u (unexplained VA loss in 2 or 2.3%) | (i) Diagnostic stratum (NVG + high-risk strata) and baseline VA were significant predictors of ≥2 Snellen line VA loss at 1-year f/u
(ii) Postoperative complications were not significant
(iii) Most frequent causes of vision loss: glaucomatous progression, corneal edema, retinal disease, cataract
(iv) 96% (24/25) of eyes that progressed to NLP VA had NVG |
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| The Ahmed Versus Baerveldt (AVB) Studies: 2013 [8], 2011 [9] | Prospective, multicenter, randomized, controlled trial | ≥18 years old; medically uncontrolled or high-risk glaucoma; randomly assigned to Ahmed or BVI placement | 114 eyes in 114 patients underwent BVI
105 eyes at 1-year f/u
90 eyes at 3-year f/u | (i) Required uncontrolled glaucoma refractory to maximum medical therapy
(ii) Included NVG, uveitic glaucoma | Units logMAR Snellen VA decrease from baseline:
1-year not stated
1.6 ± 1.2 at 3-year f/u | At 3-year f/u:
(i) 23% of BVI patients had ≥5 Snellen lines VA loss
(ii) 6 (5%) in the BVI group progressed to NLP vision | At 3-year f/u:
(i) Of 11 patients (5%) who progressed to NLP after Ahmed or BVI implantation, 7 (64%) had NVG
(ii) Did not explore reasons or risk factors for vision loss |
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| The Tube Versus Trabeculectomy (TVT) Studies: 2012 [10], 2009 [11], 2007 [12] | Prospective, multicenter, randomized, controlled trial | Medically uncontrolled glaucoma with previous CE/IOL and/or failed trabeculectomy; randomly assigned to trabeculectomy or BVI placement | 107 eyes in 107 patients underwent BVI
97 eyes at 1-year f/u
80 eyes at 3-year f/u
69 eyes at 5-year f/u | (i) Excluded cases with ICE syndrome, severe posterior blepharitis, prior cyclodestructive procedure, scleral buckle, or silicone oil placement | Units logMAR Snellen VA decrease from baseline:
0.42 ± 0.54 at baseline to 0.61 ± 0.75 at 1-year f/u
0.24 ± 0.58 at 3-year f/u
0.38 ± 0.72 at 5-year f/u | % that lost ≥2 Snellen lines VA from baseline:
32% at 1-year f/u
(unexplained vision loss in 8 patients, or 8.2%)
31% at 3-year f/u
(unexplained VA loss in 4, or 5%)
46% at 5-year f/u
(unexplained VA loss in 5, or 7.2%) | (i) Most frequent causes of vision loss were progression of glaucoma, macular disease, cataract
(ii) Postoperative complications were significantly higher if lost ≥2 Snellen lines VA (45%) than if not (20%) at 1-year f/u
(iii) Persistent corneal edema + choroidal effusions were independent predictors of vision loss at 1-year f/u |
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| Clinical experience with the Baerveldt 250-mm2 glaucoma implant [13], 2006 | Retrospective study | No prior drainage implants and underwent BVI placement between 3/96 and 12/02 | 108 eyes in 108 patients
Mean f/u of 22.8 ± 20.3 months | (i) Included all types of glaucoma | logMAR Snellen VA decrease:
(i) For all types of glaucoma: 1.32 (20/420) at baseline to 1.57 (20/750) post-op
(ii) For non-NVG: 0.98 (20/190) at baseline to 1.19 (20/310) post-op | Not addressed | Not addressed |
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| The Ahmed Shunt versus the Baerveldt Shunt for Refractory Glaucoma: A Single-Surgeon Comparison of Outcome [14, 15], 2003, 2006 | Retrospective study | Consecutive patients with refractory glaucoma; Ahmed or BVI placement; no concurrent surgeries | 70 eyes in 70 patients underwent BVI
4-year f/u | (i) Included uveitic glaucoma, NVG, aphakic patients | (i) 78% of patients had retained or improved VA compared to preoperative VA after BVI placement | 2 patients (3%) developed NLP vision in the postoperative period (reasons not specified) | Not addressed |
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| Baerveldt 350-mm2 Implant versus Ahmed Valve for Refractory Glaucoma: A Case-Controlled Comparison [16], 2004 | Retrospective study | BVI placement with no prior tube or cyclodestruction procedures | 32 eyes in 32 patients
1-year f/u | (i) Included NVG, congenital glaucoma, aphakic patients | Not addressed | 43.3% lost ≥2 Snellen lines after BVI placement | Not addressed |
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