Initial Clinical Experience With the Ahmed Glaucoma Valve Implant—Correction

Coleman, Anne L.; Wilson, M. Roy; Tam, Mae; Hill, Richard A.; Choplin, Neil T.; Kotas-Neumann, Ronit; Bacharach, Jason; Panek, William C.

doi:10.1016/s0002-9394(14)72225-1

Cited by 11 publications

(5 citation statements)

References 5 publications

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“…Glaucoma drainage devices are divided into valved and non-valved implants depending on whether they include a flow restriction mechanism to avoid hypotony or not. The most commonly used valved device is the Ahmed glaucoma implant (New World Medical, Rancho Cucamonga, CA, USA), which allows only unidirectional flow from the anterior chamber to the subconjunctival space with a minimum opening pressure of around 5 mm Hg by using a Venturi implant mechanism (Coleman et al 1995 ). The Baerveldt implant (Advanced Medical Optics, Inc., Santa Ana, CA, USA) is the most used non-valved device (Fig.…”

Section: Introductionmentioning

confidence: 99%

Analytical model for managing hypotony after implantation surgery of a glaucoma drainage device

Agujetas

Kudiesh

Fernández‐Vigo

et al. 2021

Biomech Model Mechanobiol

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The main aim of glaucoma treatment is to reduce the intraocular pressure (IOP). One of the most common surgical treatments of glaucoma is the implantation of a glaucoma drainage device to drain the aqueous humor from the anterior chamber to a filtration bleb, where the aqueous humor is absorbed. In some cases, the excess of drainage causes ocular hypotony, which constitutes a sight-threatening complication. To prevent hypotony after this intervention, surgeons frequently introduce a suture into the device tube, which increases the hydraulic resistance of the tube and, therefore, the IOP. This study aims to provide an analytical model to correct hypotony following implantation surgery of a glaucoma drainage device, which may help glaucoma surgeons decide on hypotony treatment. The results indicate that the IOP after implanting a cylindrical tube around 300 μm in diameter is essentially the same as that built up in the filtering bleb and can hardly be controlled by introducing a straight suture unless the suture diameter is slightly lower than that of the tube. On the contrary, when the tube diameter is smaller than, for example, 100 μm, significant reductions of the IOP can be obtained by introducing a thin suture into the tube.

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Section: Introductionmentioning

confidence: 99%

Analytical model for managing hypotony after implantation surgery of a glaucoma drainage device

Agujetas

Kudiesh

Fernández‐Vigo

et al. 2021

Biomech Model Mechanobiol

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“…Although the concept of GDDs was introduced over a century ago in 1906, 1 they were popularized in 1976 by Molteno et al 2 Since then, both the device design and surgical techniques have evolved to improve clinical outcomes and decrease complications. 3 , 4 Traditionally, these surgeries were performed after failed trabeculectomy or in complex glaucomas such as neovascular, uveitic, and traumatic. 4 With studies showing good long-term IOP lowering, possibly less postoperative complications vs traditional filtering procedures, and success in pediatric and complicated glaucomas, the utilization of GDD surgery, both as primary procedure and as second surgery has increased significantly over the past decade.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Locally Sourced Pericardium and Other Conventional Patch Graft Materials in a Glaucoma Drainage Device Surgery

Aggarwal¹,

Kremer²,

Engelhard³

et al. 2021

Journal of Current Glaucoma Practice

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A bstract Purpose Our study aimed to compare the outcomes and costs of various patch graft materials used in the setting of glaucoma drainage device (GDD) surgeries: conventional Tutoplast® pericardium (TP), locally-obtained Lifenet® pericardium (LP), and tissue-banked corneal (CP) and scleral (SP) patches. Design Retrospective observational study. Subjects One hundred and ninety-five eyes of 185 patients who underwent glaucoma device surgery with patch grafts were included. Materials and methods Patient records were reviewed for demographics and surgical data including age at the time of GDD surgery, race, sex, eye, history of diabetes or immunologic disease, glaucoma diagnosis, length of follow-up, pre- and postoperative intraocular pressure (IOP), type and location of GDD, patch type, and tube-related complications. Main outcome measures The primary outcome measures were rates of patch graft-related complications including conjunctival dehiscence with and without tube exposure. Secondary outcome measures were IOP control achieved and cost of patch graft materials. Results Mean follow-up for all eyes was 17.1 months. Overall, conjunctival dehiscence without tube exposure occurred in four eyes (2.1%); tube exposure was seen in six eyes (3.1%). The mean time to exposure was 3.3 months (range 1–8 months). The rate of tube exposure was 2.3% of eyes with TP grafts, 10.7% of eyes with CP grafts, 2.8% of eyes with SP grafts, and 0% of eyes with LP grafts. There was no significant difference in rates of tube exposure rates by graft material ( p = 0.26). Multivariate logistic regression analysis with adjustment for patch type, age, sex, implant type, and location revealed no significant risk factors for tube exposure. Univariate logistic regression was then performed on the same risk factors as well as diabetes, prior and concurrent ocular surgery, and showed no significance. Conclusion Our preliminary, short-term results show that locally sourced patch graft material can be a cost-effective alternative to traditionally used patch grafts without an increase in tube exposure rates. To further determine the efficacy of the different patch graft materials, longer-term comparative prospective trials are needed. Longer prospective studies are needed to compare the long-term safety and rate of tube exposures in these locally obtained patch graft materials. How to cite this article Aggarwal S, Kremer C, Engelhard S, et al. Comparison of Locally Sourced Pericardium and Other Conventional Patch Graft Materials in a Glaucoma Drainage Device Surgery. J Curr Glaucoma Pract 2021;15(1):14–18.

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“…Trabeculectomy being the most commonly performed surgical procedure for intraocular pressure (IOP) lowering, the use of glaucoma drainage devices (GDD) has historically been limited to refractory glaucoma – which is to say, high-risk cases such as secondary or neovascular glaucoma that are unresponsive either to medical therapy or conventional surgical intervention [ 1 , 2 ]. However, since the publication of the “Tube Versus Trabeculectomy” paper, which reported a landmark study showing a higher long-term success rate and a lower complication rate for GDD compared with trabeculectomy with Mitomycin C (MMC), the role of GDD has been expanding to a wider range of patients [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of 1-year outcomes after Ahmed glaucoma valve implantation with and without Ologen adjuvant

et al. 2018

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BackgroundMany studies have investigated the clinical benefits of Ologen for trabeculectomy. However, its benefits for Ahmed glaucoma valve (AGV) implantation have not been investigated as extensively. The aim of this study was to compare the 1-year outcomes of AGV implantation with and without Ologen adjuvant for the treatment of refractory glaucoma.MethodsThis retrospective study included a total of 20 eyes of 20 glaucoma patients, who were followed for at least 1-year after undergoing AGV implantation. In 12 eyes of 12 patients, conventional AGV (CAGV) surgery was performed, while in 8 eyes of 8 patients, Ologen-augmented AGV (OAGV) implantation was performed. The outcomes were evaluated according to intraocular pressure (IOP) and the number of IOP-lowering medications. Complete success was defined as IOP ≤ 21 mmHg without medications throughout the 1-year follow-up period, and qualified success was defined as IOP ≤ 21 mmHg with or without medications throughout the 1-year follow-up period.ResultsThe rate of complete success was significantly higher in the OAGV group (50.0%) than in the CAGV group (8.3%) (p = 0.035). There were no significant differences between the two groups in terms of qualified success or incidence of the early hypertensive phase. The IOP changes were similar between the groups within 1-year postoperatively, though the number of IOP-lowering medications was significantly lower in the OAGV group during the early hypertensive phase (p = 0.031, 0.031, and 0.025 at postoperative months 1, 2, and 3, respectively). When subjects were divided into groups according to the occurrence of the early hypertensive phase, the group with early hypertensive phase was more likely to use IOP-lowering medications at postoperative 6 months and 1 year (p = 0.002 and 0.005, respectively).ConclusionsOAGV surgery shows encouraging results for patients with refractory glaucoma, specifically with respect to the achievement of complete success and the reduction of the number of IOP-lowering medications during the early hypertensive phase. Furthermore, our results suggest that occurrence of the early hypertensive phase is predictive of which patients will require IOP-lowering medications at postoperative 6 months and 1 year.

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Initial Clinical Experience With the Ahmed Glaucoma Valve Implant—Correction

Cited by 11 publications

References 5 publications

Analytical model for managing hypotony after implantation surgery of a glaucoma drainage device

Analytical model for managing hypotony after implantation surgery of a glaucoma drainage device

Comparison of Locally Sourced Pericardium and Other Conventional Patch Graft Materials in a Glaucoma Drainage Device Surgery

Comparison of 1-year outcomes after Ahmed glaucoma valve implantation with and without Ologen adjuvant

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