Outcomes of Baerveldt implantation for pediatric glaucoma following surgery: a systematic review and meta-analysis.

BACKGROUND

Pediatric glaucoma following surgery (GFS) remains a serious postoperative complication with potential for vision loss. Although glaucoma drainage devices are widely used in this setting, high-quality pooled evidence on the Baerveldt glaucoma implant (BGI) in children is limited. To systematically evaluate the efficacy and safety of BGI in pediatric patients with GFS.

METHODS

Following PRISMA guidelines, five databases were searched up to August 2025. Eligible studies included pediatric cohorts (≤ 18 years) undergoing BGI after surgery, reporting intraocular pressure (IOP) outcomes or surgical success. Data were pooled using random-effects meta-analysis.

RESULTS

Five studies (116 patients) met inclusion criteria. The mean age ranged from 3.0-7.8 years, with average follow-up of 31 months. The pooled success rate of IOP control was 84.5% (95% CI 0.75-0.91), with no evidence of heterogeneity. Hypotony occurred in 7.5%, choroidal effusion in 9%, and rare events included phthisis bulbi (2%), endophthalmitis (1.4%), and corneal decompensation (3.3%).

CONCLUSION

BGI provides effective and relatively safe IOP control after surgery, with complication rates comparable to or lower than alternative surgical options. However, the current evidence is limited by small sample sizes, retrospective study designs, and short- to mid-term follow-up. Long-term, multicenter prospective studies are needed to better define its long-term safety and efficacy.