Ahmed Glaucoma Valve Implantation for Refractory Glaucoma in a Tertiary Hospital in Brazil

Abe, Ricardo Y.; Tavares, Carla Melo; Schimiti, Rui Barroso; Vasconcellos, José Paulo Cabral de; Costa, Vital Paulino

doi:10.1155/2015/850785

Cited by 12 publications

(6 citation statements)

References 28 publications

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“…3839 In fact, the treatment with aqueous suppressant has been suggested by two recent prospective studies in the early postoperative period, while IOPs were still in the low-teens to reduce the incidence of IOP spikes associated with the hypertensive phase and improve the success rate. 4041 Despite being the most frequent early complication in our study, hypertensive phase was not a risk factor for surgical failure, both in the univariate and multivariate analyses.…”

Section: Discussionmentioning

confidence: 99%

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Schimiti¹,

Abe

Tavares

et al. 2016

Journal of Current Glaucoma Practice

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AimTo evaluate the results of Ahmed glaucoma valve (AGV) in eyes with a failed trabeculectomy.Materials and methodsThis retrospective study evaluated 61 eyes with a failed trabeculectomy that underwent implantation of an AGV due to uncontrolled intraocular pressure (IOP) on maximal medical therapy. Success was defined as IOP ≤ 21 mm Hg (criterion 1) or 20% reduction in IOP (criterion 2) with or without antiglaucoma medications. Persistent hypotony, loss of light perception, and reoperation for IOP control were defined as failure.ResultsMean preoperative IOP and mean lOPs at 6, 12, and 24 months were 21.93 ± 6.32 mm Hg (n = 61), 14.15 ± 4.33 mm Hg (n = 59), 13.21 ± 4.44 mm Hg (n = 56), and 13.60 ± 3.27 mm Hg (n = 25) respectively. Mean number of antiglaucoma medications preoperatively and at 6, 12, and 24 months was 3.95 ± 0.85, 2.19 ± 1.38, 2.48 ± 1.44, and 2.40 ± 1.32 respectively. The reductions in the number of medications and IOP measurements were statistically significant at all time intervals (p < 0.001, Wilcoxon signed rank test). According to criterion 1, the Kaplan-Meier survival curve disclosed success rates of 75% at 12 and 24 months. According to criterion 2, the success rates were 57% at 12 months and 55% at 24 months. The most frequent complications were hypertensive phase (18%) and shallow anterior chamber (16.4%).ConclusionThe AGV may effectively reduce IOP in eyes that had a failed trabeculectomy.Clinical significanceThe AGV is an alternative in eyes with a failed trabeculectomy.How to cite this articleSchimiti RB, Abe RY, Tavares CM, Vasconcellos JPC, Costa VP. Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy. J Curr Glaucoma Pract 2016;10(3):97-103.

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Section: Discussionmentioning

confidence: 99%

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Schimiti¹,

Abe

Tavares

et al. 2016

Journal of Current Glaucoma Practice

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“…For example, a recent report by Perez et al [ 13 ] subjected patients to intraoperative and postoperative subconjunctival MMC injections in order to reduce the incidence of hypertensive phase (defined as IOP exceeding 21 mmHg during the first three postoperative months) among patients who underwent AC AGV implantation. Other studies have also highlighted the role of antifibrotic agents in reducing incidences of hypertensive phases in the past [ 12 , 19 , 20 ]. Even though the MMC group of the present study showed significantly lower IOP in the 1st postoperative month, when the definition of the hypertensive phase was adopted as mentioned above to calculate its rate in the two groups, no significant difference was noted ( p = 0.062).…”

Section: Discussionmentioning

confidence: 99%

Effect of Intraoperative Mitomycin C on the Surgical Outcomes of Ahmed Glaucoma Valve Implantation with Ciliary Sulcus Tube Placement

Kim¹,

Kim²,

Lee³

et al. 2023

Korean J Ophthalmol

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Purpose: To evaluate the effect of intraoperative mitomycin C (MMC) on the surgical outcomes of ciliary sulcus (CS) Ahmed glaucoma valve (AGV) tube placement.Methods: A retrospective review of medical records of 54 consecutive patients who underwent AGV implantation with tube placed in CS was performed. Consecutive cases operated without the use of intraoperative MMC from 2017 to 2019 were compared with consecutive cases operated with MMC from 2019 to 2021. Surgical failure was defined as intraocular pressure (IOP) exceeding 21 mmHg in two consecutive visits after postoperative 3 months or ≤30% IOP reduction, IOP ≤5 mmHg in two consecutive visits, or loss of light perception. Kaplan-Meier survival analysis and log-rank test were performed to compare the surgical failure rates.Results: A total of 54 eyes of 54 patients were investigated. Mean follow-up period after AGV implantation was 1.4 ± 0.8 years. The MMC group showed significantly lower IOP during the 1st postoperative month (20.5 ± 8.6 mmHg vs. 15.8 ± 6.4 mmHg, p = 0.027), but the difference did not persist 6 months after the surgery (p = 0.805). The mean number of postoperative antiglaucoma medications was significantly lower in the MMC group in the 1st postoperative month (p = 0.047) but no difference was found at 6 months. No statistical difference was noted in the rates of postoperative complications. Kaplan-Meier survival analysis showed comparable survival rates between MMC group and no MMC group (p = 0.356).Conclusions: The intraoperative use of MMC significantly lowered IOP in the 1st postoperative month but did not increase 6 months success rates in patients receiving AGV tube placement in CS.

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“…Treatment of NVG consists of pharmacological treatment with IOP-lowering agents combined with surgical interventions. [1819] There is no consensus on the optimal surgery for this condition. Trabeculoplasty and trabeculectomy are known to increase filtration and reduce IOP.…”

Section: Discussionmentioning

confidence: 99%

Cyclophotocoagulation with an illuminated laser probe under a noncontact wide-angle retinoscope: A modified technique of ciliary body photocoagulation

Qian¹,

Cai

Huang

et al. 2019

Indian J Ophthalmol

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Purpose: This study aimed to investigate the efficacy of cyclophotocoagulation with an illuminated laser probe under a noncontact wide-angle retinoscope in treating refractory glaucoma. Methods: Eleven patients (11 eyes) with refractory neovascular glaucoma were treated with ciliary body photocoagulation. Preoperative and postoperative corrected visual acuity, intraocular pressure (IOP), ophthalmofundoscopy, B-ultrasound and ultrasound biomicroscopy, optical coherence tomography, and fundus fluorescein angiography were performed. Results: Preoperative IOP ranged from 45 to 58 mmHg (mean 51.9 mmHg). At postoperative 1, 3, and 6 months, the IOPs ranged between 16 and 33 mmHg (mean 27.1 mmHg), 14–28 mmHg (mean 20.6 mmHg), and 14–28 mmHg (mean 18.5 mmHg), respectively. IOP at the last follow-up (range 7–12 months) was 15–24 mmHg (mean 18.8 mmHg). An average of 63.8% decrease in postoperative IOP was found in these patients with no associated complications. The postoperative fibrotic exudate, anterior chamber hyphema, and exudative choroidal detachment were all well-managed and resolved. No patients experienced intraocular lens deviation or dislocation, hypotonia oculi, atrophy of eyeball, retinal detachment, endophthalmitis, or sympathetic ophthalmia. Conclusion: Cyclophotocoagulation with an illuminated laser probe under a noncontact wide-angle retinoscope is a safe and effective technique for the treatment of neovascular glaucoma.

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Ahmed Glaucoma Valve Implantation for Refractory Glaucoma in a Tertiary Hospital in Brazil

Cited by 12 publications

References 28 publications

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Effect of Intraoperative Mitomycin C on the Surgical Outcomes of Ahmed Glaucoma Valve Implantation with Ciliary Sulcus Tube Placement

Cyclophotocoagulation with an illuminated laser probe under a noncontact wide-angle retinoscope: A modified technique of ciliary body photocoagulation

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