Glaucoma drainage devices: pros and cons

Assaad, Manal H.; Baerveldt, George; Rockwood, Edward J.

doi:10.1097/00055735-199904000-00012

Cited by 73 publications

(44 citation statements)

References 35 publications

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“…AGV consists of three parts: (1) a plate which, depending on the model, is composed of medical grade silicone, polypropylene or polyethylene (Medpor; Porex, Atlanta, GA, USA; subsequently Stryker, Kalamazoo, MI, USA), (2) a drainage tube composed of medical grade silicone, and (3) a valve mechanism made of medical-grade silicone (Fig. 1a).…”

Section: Ahmed Glaucoma Valve: Device Description and Technical Datamentioning

confidence: 99%

“…The adult model (S2) of AGV provides 184 mm 2 of total plate area, while the pediatric model (S3) provides a total area of 96 mm 2 . Obviously, a smaller plate facilitates positioning in infants and subjects with a small eye.…”

Section: Ahmed Glaucoma Valve: Device Description and Technical Datamentioning

confidence: 99%

“…Glaucoma drainage implants (GDIs) have become a valuable tool for the surgical management of refractory glaucoma [1,2]. GDIs have been demonstrated to be effective in reducing intraocular pressure (IOP) and are especially indicated in cases with high risk of failure after filtering procedures [3,4].…”

Section: Introductionmentioning

confidence: 99%

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A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

et al. 2017

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The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma.

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Section: Ahmed Glaucoma Valve: Device Description and Technical Datamentioning

confidence: 99%

Section: Ahmed Glaucoma Valve: Device Description and Technical Datamentioning

confidence: 99%

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A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

et al. 2017

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“…While these methods are successful in lowering IOP, long-term visual acuity outcomes have been variable. [12][13][14][15][16][17][18][19][20] Inhibition of VEGF-A by bevacizumab has been shown to be successful in causing short-term regression of retinal neovascularization. Recently, intravitreal injection of this agent has demonstrated rapid regression of neovascularization of the iris (NVI).…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Bevacizumab for Neovascular Glaucoma

Vasudev

Blair

Galasso

et al. 2009

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To report 6-month and 1 year outcomes of eyes treated for neovascular glaucoma (NVG) with intravitreal bevacizumab injection and panretinal laser (PRP) compared to those receiving PRP alone. Design: retrospective, consecutive case series. Methods: Charts of patients with NVG from retinal ischemia and at least 6 months of follow-up were reviewed. Patients were treated with one injection of 1.25 mg intravitreal bevacizumab followed by PRP or with PRP alone. The primary outcome was the long-term angle anatomy. Secondary measures included intraocular pressure (IOP), visual acuity, patient compliance, and control of systemic diseases. Results: Fourteen eyes of 12 patients treated with bevacizumab and PRP and 15 eyes of 11 patients treated with PRP alone were included in the study. Mean sectors of open angle at baseline was 1.31 in the bevacizumab group and 1.47 in the retinal ablation group (P = 0.73). Mean sectors of open angle was 2.14 and 1.18 in the bevacizumab and retinal ablation groups, respectively (P < 0.05) at 6-month follow-up, and 2.27 and 1.18, respectively (P < 0.05) at 1-year follow-up. Mean baseline IOP was 32.3 mmHg (±14.8) in the bevacizumab group and 31.8 mmHg (±13) in the PRP group (P = 0.75). At 6-month follow-up, the mean IOP was 18.28 mmHg (±10) in the bevacizumab group and 23.33 mmHg (±14.6) in the PRP group (P = 0.05), and 19.12 mmHg (±6.8) and 26.2 mmHg (±18) (P = 0.1), respectively at 1-year follow-up. Nineteen patients were judged to be noncompliant, 10 had uncontrolled diabetes and 7 had uncontrolled hypertension. Conclusions: This study documents better long-term preservation of open angle and IOP control in eyes receiving bevacizumab along with PRP. We stress that NVG is still associated with poor visual acuity outcomes.

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“…Previous investigators have reported a high incidence of corneal graft failure, varying between 20 and 50% after drainage tube insertion for the treatment of glaucoma. [6][7][8] The presence of a glaucoma drainage device was considered by many to be associated with a worse prognosis for graft survival, 6,7,9-11 and a significant and independent risk factor for corneal graft failure. 12 The mechanism for graft failure in these patients is not fully understood.…”

Section: Introductionmentioning

confidence: 99%

The effects of glaucoma filtering surgery on anterior chamber-associated immune deviation and contribution of lymphatic drainage in rats

Lü

et al. 2008

Eye

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Purpose To investigate whether glaucoma filtering surgery (GFS) in rats would impair the eye's capacity to induce anterior chamberassociated immune deviation (ACAID) and assess the possible mechanism involved. Methods Rats subjected to GFS were injected with bovine serum antigen (BSA) into the anterior chamber to induce ACAID. Animals that had their cervical lymph nodes (CLNs) excised before filtering surgery and those that had sham filtering surgery served as control comparison groups. Antigen-specific delayed-type hypersensitivity (DTH) was used to identify the induction of ACAID. Antigen level in the CLNs was indicated by the percentage of FITC-positive cells in CLNs after FITC dextran was injected into the anterior chamber. Statistical analyses were performed using the student's t-test for comparison of data between control and experimental groups. A Po0.05 was required for results to be considered statistically significant. Results Rats undergoing GFS demonstrated antigen-specific DTH, while those in the sham filtering surgery or CLNs excised groups failed to acquire an antigen-specific DTH response. The percentage of FITC-positive cells in CLNs was significantly increased (P ¼ 0.001) in GFS (mean ± SD: 2.96 ± 0.67%) vs controls (1.57 ± 0.48%) at 1 day, but not at 3, 5, 7, or 12 days post-antigen injection Conclusions GFS prevents the induction of ACAID in rats, and the antigen drainage to CLNs plays a critical role in this process. The results suggest that the ocular immune status might be altered by GFS.

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Glaucoma drainage devices: pros and cons

Cited by 73 publications

References 35 publications

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

Intravitreal Bevacizumab for Neovascular Glaucoma

The effects of glaucoma filtering surgery on anterior chamber-associated immune deviation and contribution of lymphatic drainage in rats

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