Baerveldt shunts can reduce enuclation rate, lower IOP in eyes with uveal melanoma

This prospective study found that Baerveldt shunts were effective at lowering IOP, with few complications, in glaucomatous eyes treated with total anterior segment irradiation for anterior uveal melanoma (AUM).

The authors implanted Baerveldt aqueous shunts in 31 eyes with uncontrolled IOP following anterior segment proton beam radiation therapy for AUM. Surgical success was defined as IOP of 21 mmHg or less and 20 percent reduction from baseline. Mean follow-up was 15.7 months. Mean interval from irradiation to shunt implantation was 2.5 years. The majority of shunt implantations (90 percent) were performed as primary surgery.

Mean IOP decreased from 31 mmHg preoperatively to 15.0 mmHg at the last visit, and mean glaucoma medications used decreased from 3.3 to 0.7. The surgical success rate at 12 months was 86 percent with glaucoma medications. Four eyes had minor postoperative complications, none of which were sight threatening. There were no local tumor recurrences or systemic metastases, and there were no enucleations caused by ocular hypertension.

The authors write that longer follow-up and greater numbers are required to determine whether systemic metastatic rates of shunted eyes differ from those of nonshunted eyes.