The Results of the Use of Ahmed Valve in Refractory Glaucoma Surgery

Бикбов, М.М.; Хуснитдинов, И. И.

doi:10.5005/jp-journals-10008-1191

Cited by 19 publications

(9 citation statements)

References 71 publications

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“…Trabeculectomy (TE) was first proposed and applied by Cairns in 1968 [ 4 ], which was widely regarded as the gold standard for primary open angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). However, the its success rate was about 11-52% [ 5 , 6 ], and it can lead to some eye complications. At present, modified TE for which traditional TE plus scleral flap adjustable suture or antimetabolites in the intraoperative and postoperative (e.g., MMC and 5-FU) has become a new trend in the clinical treatment of glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Modified Trabeculectomy versus Glaucoma Drainage Implant Surgery: A Retrospective Comparative Study for Refractory Glaucoma Treatment

et al. 2022

Oxidative Medicine and Cellular Longevity

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Purpose. To observe and compare the efficacy of modified trabeculectomy (TE), Ahmed drainage valve implantation (AGV), and EX-PRESS glaucoma shunt for refractory glaucoma (RG). Methods. The study population of this retrospective study comprised 73 patients (76 eyes) who were suffering from RG and treated with modified TE, AGV, and EX-PRESS glaucoma shunt in our hospital from October 2012 to October 2020. The number of cases who underwent modified TE, AVG, and EX-PRESS glaucoma shunt was 36 (38 eyes). 19 (20 eyes), and 18 patients (18 eyes), respectively. The intraocular pressure (IOP), best-corrected visual acuity (BCVA), postoperative antiglaucoma medications, filter bubble morphology, anterior chamber depth (ACD), successful rate, and postoperative complications were recorded and statistically analyzed preoperative and 1 d, 1 w, 1 mon, 3 mon, 6 mon, and the end follow-up after operation. Results. The BCVA differed insignificantly among the three cohorts before and 6 months after surgery. Compared to preoperative BCVA, the postoperative BCVA of the three groups had no statistical significance. An obvious reduction in IOP was observed in all the three group after operation ( P < 0.05 ). An obvious decrease in antiglaucoma medications was observed after surgery in all the three groups ( P < 0.05 ). The AGV group showed deeper ACD postoperatively, while no marked difference was found in postoperative ACD in the other two groups. The total success rates in modified TE and AGV groups were slightly higher than those in the EX-PRESS group. The three groups differed insignificantly in filter bubble morphology after operation. Conclusion. Modified TE, AGV, and EX-PRESS glaucoma shunt showed equivalent efficacy for RG, which could validly reduce IOP and postoperative antiglaucoma medications. However, the success rates of modified TE and AGV were slightly higher than those of EX-PRESS glaucoma shunt in the last follow-up, and their complications were slightly less than those of the EX-PRESS glaucoma shunt.

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Section: Introductionmentioning

confidence: 99%

Modified Trabeculectomy versus Glaucoma Drainage Implant Surgery: A Retrospective Comparative Study for Refractory Glaucoma Treatment

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…В результате работы было установлено, что трубка клапана в отдаленном послеоперационном периоде мигрирует, особенно в глазах с вторичной глаукомой, после сквозной кератопластики и хроническим увеите. Авторы на основании полученных результатов рекомендуют имплантировать клапан Ahmed с достаточным запасом длины трубки в таких глазах для предупреждения смещения трубки в слои склеры и обтурации его просвета [29,30].…”

Section: Introductionunclassified

Evaluation of the Results of Glaucoma Surgery Using Optical Coherent Tomography (Literature Review)

Хуснитдинов

2019

Oftalʹmologiâ

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Optical coherence tomography (OCT) is a noncontact method that provides two-dimensional (three-dimensional for some models) highresolution images of the anterior eye segment, with an axial resolution in the range from 3 to 20 µm. Two OCT diagnostics platforms are available: time-domain and spectral OCT. OCT provides a qualitative and quantitative assessment of the most important structures involved in the glaucoma pathogenesis: the state of the optic nerve head, the thickness of the nerve fiber layer, the anterior chamber angle and the trabecular apparatus. The OCT advantage is the ability to visualize surgically formed outflow tracts in the early postoperative period after antiglaucoma surgery. The OCT studies of the antiglaucomatous surgery zone are presented in detail in the literature, namely, the assessment of such biometric parameters of filtering bleb (FB) as wall thickness and reflectivity, radial length and height. According to the literature, the presence of a multi-layer filtration cushion 6 months after the operation indicates a favorable prognosis for the duration of the hypotensive effect of the operation. Such signs as low reflectivity of the filtration cushion wall and the presence of episcleral fluid are in most cases associated with a successful outcome of trabeculectomy. OCT studies of a filtration cushion after trabeculectomy make it much easier to choose an area for revision and nidling. In addition, OCT is used to assess anatomical features in the field of surgical intervention with drains and drainage devices. Currently OCT is widely implemented at the prehospital stage, however, engineers did not stop at the achieved level and carried out the integration of spectral OCT with an operating microscope. The possibilities of intraoperative imaging with cataract phacoemulsification (FEC) and trabeculectomy, implantation of the Ahmed valve, reconstruction of the anterior chamber angle, revision of the filtration bag and nidlinge are described in the literature. Conclusion. OCT is a very valuable method of intravital imaging of the antiglaucoma operation zone. It allows assessing the level of retention of intraocular fluid, determining the functional activity, the location of drains and drainage devices both in the early and late postoperative period.

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“…К сожалению, эффективность хирургического лечения глаукомы со временем снижается и у 20-30 % больных офтальмотонус вновь повышается. Чаще всего причиной является послеоперационное избыточное рубцевание тканей глаза в зоне вмешательства, которое наиболее часто проявляется в виде склеро-конъюнктивальных и склеро-склеральных сращений [3][4][5][6][7].…”

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Comparison of the Effectiveness of Antiglaucomatous Surgeries with Various Glautex Drainage Models

Хуснитдинов¹,

Babushkin²

2019

Oftalʹmologiâ

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Purpose: comparative study of trabeculectomy results with various models of domestic “Glautex” drainage in the surgical treatment of primary open angle glaucoma (POAG). Patients and methods. The results of surgical treatment of 98 (105 eyes) patients with POAG aged 50–83 years who underwent trabeculectomy with various Glautex drainage models were analyzed. There were 43 men (43.9 %) and 55 (56.1 %) women. The second (II) stage of POAG was diagnosed in 49 eyes (46.7 %), the third (III) stage in 56 (53.3 %). All patients were divided into 3 groups. The first (main) group consisted of 34 (37 eyes) patients who underwent trabeculectomy in combination with the implantation of Glautex DDA drainage model. The second (main) group included 29 (30 eyes) patients with trabeculectomy and implantation of the SDA model of this drainage. The third group was the control group and consisted of 35 (38 eyes) patients with the classical method of surgery without using any drainage. Results. There was a significant 71.7 % decrease in IOP compared with baseline data in the 1st patients group after antiglaucomatous surgery, 72 and 74 % decrease was in the 2nd and 3rd groups respectively (p < 0.05). An increase in IOP was noted predominantly in the control and in the second study group within 1 month of follow-up. Normalization of ophthalmotonous pressure was achieved by using needling in 13.3 % (4/30) patients in the second group, in 7.9 % (6/38) cases in the control group. The absolute hypotensive effect in the 1st group was noted in 75.7 % of cases; the relative hypotensive effect was in 8.1 %; total failure was in 16.2 %. In the 2nd group the absolute hypotensive effect of the surgery was in 73.3 % of 30 cases, the relative was in 6.7 %, total failure was in 20 %. In the control group (38 eyes), absolute success was in 63.1 %, the relative hypotensive effect was in 13.2 %, and the total failure was in 23.7 %. Conclusion. Trabeculectomy with Glautex drainage and with various models in case of primary open-angle glaucoma provided a sufficiently high relative hypotensive effect in 82 % of cases in a year after the surgery. The achieved surgery outcomes with this drainage in the studied periods did not depend on applied model: DDA or SDA (83.8 and 80 % respectively), but was higher than the classical trabeculectomy (76.3 %). However, in case of the SDA model, needling was required in 13.3 % of cases in the early postoperative period.

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The Results of the Use of Ahmed Valve in Refractory Glaucoma Surgery

Cited by 19 publications

References 71 publications

Modified Trabeculectomy versus Glaucoma Drainage Implant Surgery: A Retrospective Comparative Study for Refractory Glaucoma Treatment

Modified Trabeculectomy versus Glaucoma Drainage Implant Surgery: A Retrospective Comparative Study for Refractory Glaucoma Treatment

Evaluation of the Results of Glaucoma Surgery Using Optical Coherent Tomography (Literature Review)

Comparison of the Effectiveness of Antiglaucomatous Surgeries with Various Glautex Drainage Models

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