Pars Plana Vitrectomy and Ahmed Valve Implantation for Intractable Glaucoma Comorbid With Retinal Disorders

Purpose: To evaluate surgical results after combined operation associated with Ahmed glaucoma valve (AGV) implantation. Methods: A retrospective review was performed for 71 eyes of 67 patients who underwent combined operation associated with AGV implantation from June 2003 to August 2012. Results: Pars plana vitrectomy or phacoemulsification combined with AGV implantation were performed for 16 eyes and AGV implantation alone was performed in 55 eyes. Mean IOP (mm Hg) and the number of antigluacoma agents for both the combined and single groups showed a statistically significant decrease (combined/single; p = 0.008/0.000, 0.002/ 0.000). Visual acuity (log MAR) was improved, but these differences were not statistically significant (combined/single; p = 0.309/0.052). Conclusions: Combined vitrectomy or phacoemulsification and AGV implantation for intractable glaucoma with vitreoretinal disease or cataract is considered to be the primary procedure because of its equivalent efficacy in lowering IOP, improving visual acuity and decreasing the number of glaucoma agents. J Korean Ophthalmol Soc 2014;55(4):578-584

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Combined Operation Assosciated with Ahmed Glaucoma Valve Implantation

Kim

Park

et al. 2014

J Korean Ophthalmol Soc

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Long-Term Outcome of Ahmed Valve Implantation Combined with 23-Gauge Vitrectomy in Eyes with Neovascular Glaucoma

Jung

Kim

Heo

et al. 2016

J Korean Ophthalmol Soc

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Purpose: To investigate the surgical outcome of Ahmed glaucoma valve implantation (AVI) combined with 23-gauge vitrectomy in eyes with medically uncontrolled neovascular glaucoma (NVG). Methods: Thirty six eyes of 35 NVG patients who underwent AVI combined with 23-gauge vitrectomy and have been followed-up at least 6 months after surgery and were retrospectively reviewed. Surgical success was defined as the control of intraocular pressure (IOP) between 6 and 21 mm Hg, irrespective of the use of topical IOP lowering medications. Surgical failure was defined as the failure of IOP control or visual acuity aggravated to no light perception after the surgery. Overall success rate, median survival time, and clinical factors associated with survival time were investigated. Results:The overall success rate was 63.2% after a mean of 34.0 ± 31.7 months postoperative follow-up. The success rate was 83.3% at postoperative 6 months, 72.7% at postoperative 12 months and 63.2% at postoperative 3 years. The underlying retinal diseases were proliferative diabetic retinopathy (PDR; n = 20, 55.5%), central retinal vein occlusion (CRVO; n = 12, 33.3%), ocular ischemic syndrome (n = 2, 5.6%), and other retinal vascular diseases (n = 2, 5.6%). The survival times were significantly shorter in eyes with CRVO (20.2 ± 30.5 months) compared to PDR (33.1 ± 30.8 months), and in phakic eyes (33.1 ± 30.8 months) compared to pseudophakic eyes (37.7 ± 35.4 months) (p < 0.05). In the multivariate analysis, preoperative phakic eyes were significantly associated with a shorter survival time (hazard ratio = 5.626, p = 0.030). Conclusions: Combined surgery of Ahmed glaucoma valve implantation and 23-gauge vitrectomy showed favorable outcome in the treatment of medically uncontrolled NVG. Preoperative lens status may affect the long-term success rate in such patients.

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Pars Plana Vitrectomy and Ahmed Valve Implantation for Intractable Glaucoma Comorbid With Retinal Disorders

Abstract: orders show long-term efficacy in lowering IOP. J Korean Ophthalmol Soc 2011;52(1):46-52

Cited by 2 publications

References 20 publications

Combined Operation Assosciated with Ahmed Glaucoma Valve Implantation

Combined Operation Assosciated with Ahmed Glaucoma Valve Implantation

Long-Term Outcome of Ahmed Valve Implantation Combined with 23-Gauge Vitrectomy in Eyes with Neovascular Glaucoma

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