Choroidal Detachment After Baerveldt Glaucoma Implant Surgery: Incidence and Risk Factors.

Purpose: To investigate the incidence and risk factors for postoperative choroidal detachment (CD) following Baerveldt glaucoma implant (BGI) surgery. Patients and Methods: We conducted a retrospective cohort study including adult patients who underwent BGI surgery using a 350-mm Results: We analyzed the data of 261 eyes, and postoperative CD developed in 48 eyes (18.4%). Eyes with CD were significantly older and showed lower postoperative day 1 IOP and the lowest postoperative IOP within 7 days compared with those without CD. Multivariable analysis revealed that older age (odds ratio [OR] 1.06 per year, P < 0.01) and greater postoperative IOP reduction (OR 1.08 per mmHg, P < 0.01) were independently associated with CD. Among the eyes with CD, 37 were classified as early onset and 11 as delayed onset. Exploratory analyses suggested that early-onset CD tended to be associated with a greater number of previous intraocular surgeries, longer axial length, differences in tube insertion site, and lower postoperative day 1 IOP compared with delayed-onset CD. Conclusion: Older age and greater postoperative IOP reduction were independently associated with CD after BGI surgery, suggesting that rapid postoperative IOP reduction may play an important role in CD pathogenesis. Early- and delayed-onset CD may reflect different postoperative mechanisms of aqueous humor dynamics following BGI surgery.