Pars Plana Ahmed Valve and Vitrectomy in Patients With Glaucoma Associated With Posterior Segment Disease

Wallsh, Josh; Gallemore, Ron P.; Taban, Mehran; Hu, Chunhua T.; Sharareh, Behnam

doi:10.1097/iae.0b013e31828992c3

Cited by 22 publications

(25 citation statements)

References 30 publications

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“…Wallsh et al confirmed these findings in a retrospective study with a 22 patients, in which 95.8 % of eyes had IOP below 21 mmHg in the final follow-up (mean follow-up of 7.39 ± 1.11 months). Best-corrected visual acuity also improved significantly [88]. Finally, a retrospective study evaluated the results of combined pars plana vitrectomy and pars plana Baerveldt tube placement.…”

Section: Introductionmentioning

confidence: 99%

Neovascular glaucoma: a review

et al. 2016

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Neovascular glaucoma (NVG) is a secondary glaucoma generally associated with poor visual prognosis. The development of new vessels over the iris and the iridocorneal angle can obstruct aqueous humor outflow and lead to increased intraocular pressure. The underlying pathogenesis in most cases is posterior segment ischemia, which is most commonly secondary to proliferative diabetic retinopathy or central vein retinal occlusion. The neovascularization process in the eye is driven by the events that alter the homeostatic balance between pro-angiogenic factors, such as the vascular endothelial growth factor and anti-angiogenic factors, such as the pigment-epithelium-derived factor. Early diagnosis of this condition through slit lamp examination of the iris, iridocorneal angle and retina can help to avoid the development of goniosynechia and obstruction of aqueous humor outflow, with consequent intraocular pressure elevation. Historically, NVG treatment was focused on reducing the posterior segment ischemic process that caused the formation of new vessels, through panretinal photocoagulation. Recently, several studies have investigated the application of intravitreal anti-VEGF therapies in NVG. If clinical treatment with the use of hypotensive topical drops is not sufficient, laser and/or surgical procedures are required for intraocular pressure control.

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Section: Introductionmentioning

confidence: 99%

Neovascular glaucoma: a review

et al. 2016

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“…The latter did not show any of these adverse effects since its introduction in clinical use. [98][99][100][101][102] Moreover, our study did not show any of these complications either.…”

Section: Discussionmentioning

confidence: 76%

One-Year Feasibility Study of Replenish MicroPump for Intravitreal Drug Delivery: A Pilot Study

Gutiérrez-Hernández

Caffey²,

Abdallah

et al. 2014

Trans. Vis. Sci. Tech.

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Citation: Gutiérrez-Hernández J-C, Caffey S, Abdallah W, et al. One-year feasibility stuff of replenish MicroPump for intravitreal drug delivery: a pilot study. Tran Vis Sci Tech. 2014; 3(4):1, http://tvstjournal.org/doi/full/ 10. 1167/tvst.3.4.1, doi:10.1167/ tvst.3.4.1 Purpose: To determine the feasibility of the surgical procedure and to collect some safety data regarding the bioelectronics of a novel micro drug pump for intravitreal drug delivery in a Beagle dog model for up to 1 year.Methods: Thirteen Beagle dogs were assigned to two groups. The experimental group (n ¼ 11) underwent pars plana implantation of MicroPump; the body of which was sutured episclerally, while its catheter was secured at a pars plana sclerotomy. The control group (n ¼ 2) underwent sham surgeries in the form of a temporary suturing of the MicroPump, including placement of the pars plana tube. Baseline and follow-up exams included ophthalmic examination and imaging. The experimental animals were euthanized and explanted at predetermined time points after surgery (1, 3, and 12 months), while the control animals were euthanized at 3 months. All operated eyes were submitted for histopathology.Results: Eyes were scored according to a modified McDonald-Shadduck system and ophthalmic imaging. Neither the implanted eyes nor the control eyes showed clinically significant pathological changes beyond the expected surgical changes. The operated eyes showed neither significant inflammatory reaction nor tissue ingrowth through the sclerotomy site compared with the fellow eyes.Conclusion: This study shows that the Replenish Posterior MicroPump could be successfully implanted with good safety profile in this animal model. Translational Relevance:The results of this study in a Beagle dog model are supportive of the biocompatibility of Replenish MicroPump and pave the way to the use of these devices for ocular automated drug delivery after further testing in larger animal models.

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“…Glaucoma drainage implants, trabeculectomy with mitomycin C, cyclocryotherapy, or diode laser coagulation of the ciliary body is another treatment option available for the treatment of recalcitrant and end-stage NVG [ 4 – 6 ]. Pars plana vitrectomy (PPV) combined with glaucoma drainage implantation can produce good control of intraocular pressure (IOP) in NVG patients with PDR [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of 23-Gauge Vitrectomy Combined with Phacoemulsification, Panretinal Photocoagulation, and Trabeculectomy without Use of Anti-VEGF Agents for Neovascular Glaucoma with Vitreous Hemorrhage

Yan

2016

Journal of Ophthalmology

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Purpose. To evaluate the outcomes of 23-gauge vitrectomy combined with phacoemulsification, PRP and trabeculectomy without use of anti-VEGF-agents for NVG. Methods. Eighteen eyes of 18 patients with NVG underwent 23-gauge vitrectomy combined with phacoemulsification, PRP and trabeculectomy without use of anti-VEGF agents. The preoperative BCVA ranged from light perception to 0.2. The preoperative IOP ranged from 38 mmHg to 64 mmHg with a mean of 54 ± 8 mmHg. The average follow-up time was 14.5 ± 3 months with a range from 11 to 24 months. Results. The postoperative VA increased in 14 eyes and was stable in 4 eyes at the final follow-up. The mean IOP was 12 ± 3 mmHg at postoperative day 1. The mean IOP was 15 ± 2 mmHg, 16 ± 3 mmHg, 23 ± 5 mmHg, 28 ± 4 mmHg, 22 ± 5 mmHg, 17 ± 3 mmHg, and 19 ± 4 mmHg at postoperative days 2 and 3, 1, 2, 3, and 12 weeks, and 1 year postoperatively, respectively, with a range from 10 to 30 mmHg at the final follow-up time point of one year. The IOP was significantly lower than the preoperative one 12 weeks postoperatively (p < 0.05). Conclusion. 23-gauge vitrectomy combined with phacoemulsification, PRP, and trabeculectomy without use of anti-VEGF-agents is a safe and effective method in treating NVG.

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Pars Plana Ahmed Valve and Vitrectomy in Patients With Glaucoma Associated With Posterior Segment Disease

Abstract: Ahmed valve placement through the pars plana during vitrectomy is an effective option for managing complex cases of glaucoma without the use of the pars plana clip.

Cited by 22 publications

References 30 publications

Neovascular glaucoma: a review

Neovascular glaucoma: a review

One-Year Feasibility Study of Replenish MicroPump for Intravitreal Drug Delivery: A Pilot Study

Outcomes of 23-Gauge Vitrectomy Combined with Phacoemulsification, Panretinal Photocoagulation, and Trabeculectomy without Use of Anti-VEGF Agents for Neovascular Glaucoma with Vitreous Hemorrhage

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