A retrospective study on the outcomes of Ahmed valve versus Ahmed valve combined with fluocinolone implant in uveitic glaucoma

Sevgi, Duriye Damla; Davoudi, Samaneh; Talcott, Katherine E.; Cho, Heeyoon; Guo, Rong; Lobo, Ann-Marie; Papaliodis, George N.; Turalba, Angela; Sobrin, Lucia; Shen, Lucy Q.

doi:10.5693/djo.01.2017.06.001

Cited by 10 publications

(6 citation statements)

References 29 publications

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“…Prior studies have reported similar outcomes from the combined placement of a sustained-release fluocinolone acetonide intravitreal implant with glaucoma drainage device among patients with uveitic glaucoma. 9,[11][12][13][14][15][16] These results were consistent among a variety studies that included patients with single-session combined surgery (with or without concurrent cataract extraction) and/or consecutive glaucoma drainage device placement following fluocinolone acetonide intravitreal implantation.…”

Section: Discussionsupporting

confidence: 74%

“…Their study found 2 eyes that underwent reoperation, including one within the first 30 days following surgery for tube repositioning. 11 Sevgi et al 16 also noted 2 tube erosions in the same patient among 7 eyes that underwent combined surgery. Moore et al 11 reported adverse events in 2 of 22 eyes, including 1 eye that lost light perception vision, and 1 eye that required an additional IOP-lowering procedure.…”

Section: Discussionmentioning

confidence: 87%

“…Moore et al 11 release may help slow the development of the inflammationmediated fibrous capsule surrounding the glaucoma drainage device plate that is implicated in accelerated failure to control IOP. In addition, Sevgi et al 16 reported that fewer glaucoma medications were required in uveitic eyes that received combined surgery with the fluocinolone intravitreal implant and that this group had better inflammation control than the group that received glaucoma drainage device alone. Conversely, a study by Zivney et al 13 suggested no additional benefit from the fluocinolone acetonide intravitreal implant among patients with uveitic glaucoma undergoing glaucoma drainage device placement.…”

Section: Discussionmentioning

confidence: 99%

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Response to: Combined Dexamethasone Intravitreal Implant and Glaucoma Drainage Device Placement for Uveitic Glaucoma

Nguyen

Liu²

2020

Journal of Glaucoma

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Precis: At 1-year postoperative follow-up, concurrent placement of a dexamethasone intravitreal implant and glaucoma drainage device effectively controlled intraocular pressure (IOP) and inflammation in eyes with uveitic glaucoma with no changes in systemic immunomodulatory therapy. Purpose: The purpose of this study was to assess 1-year postoperative outcomes in eyes with uncontrolled uveitic glaucoma following concurrent placement of a dexamethasone intravitreal implant and glaucoma drainage device. Materials and Methods: This is a retrospective, observational case series of patients with chronic, noninfectious uveitis and uveitic glaucoma uncontrolled on maximal tolerated medical therapy with at least 1-year postoperative follow-up. The main outcomes were visual acuity, IOP, number of glaucoma medications, recurrent inflammation, frequency of topical steroids, systemic immunomodulatory therapy, and adverse events. Success was defined as IOP < 21 mm Hg and IOP reduced by > 20% from baseline on at least 2 consecutive visits after 3 months either with or without glaucoma medications (ie, partial or complete success, respectively). Results: Eight eyes in 6 patients met the inclusion criteria. The average age was 44.1 ± 19.7 years (range: 10 to 68 y) and 50% were female. At 1-year, there was no significant change in visual acuity. No eyes lost ≥ 3 lines of vision. The majority of eyes (87.5%) achieved complete (n = 2) or partial success (n = 5) with a decrease in average IOP from 36.5 to 11.8 mm Hg (P = 0.002). Glaucoma medication use decreased from 3.0 to 1.3 medications (P = 0.04). There was a significant decrease in the number of episodes of recurrent inflammation in the 6 months following surgery compared with the 6 months before surgery (P = 0.004). Conclusion: In this small case series, dexamethasone intravitreal implant combined with Ahmed glaucoma drainage device appears to be an effective approach for the management of uncontrolled uveitic glaucoma.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Response to: Combined Dexamethasone Intravitreal Implant and Glaucoma Drainage Device Placement for Uveitic Glaucoma

Nguyen

Liu²

2020

Journal of Glaucoma

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“…9 Sevgi et al found the presence of inflammation did not change significantly in the Ahmad Glaucoma Valve (AGV), the only group compared to the AGV+ fluocinolone implant group. 10 In line with Sevgi et al, Zivney et al found fluocinolone implant had better control intraocular inflammation. 10,11 Figure 3 showed the number of glaucoma medications was decreased postoperatively in all studies on average Generally, common complications were hypotony, choroidal effusion, hyphema, shallow anterior chamber, blocked tube, and corneal edema.…”

Section: Reviewmentioning

confidence: 73%

Glaucoma drainage devices implantation in uveitic glaucoma: a systematic review

Emily¹,

Satolom²,

Kasih³

et al. 2021

Intisari Sains Medis

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Background: Uveitis is broadly defined as inflammation of the uvea. Glaucoma is the third most common complication of uveitis. Uveitic Glaucoma (UG) is known to be refractory, and multiple surgeries are often required for proper treatment. The purpose of this study is to determine the effectiveness of Glaucoma Drainage Device (GDD) implantation as a surgical procedure in UG patients. Method: We conducted a systematic search of electronic databases from PubMed, Science Direct, and SpringerLink using a combination of relevant keywords was performed by 5 independent reviewers. Various search terms, including 'glaucoma drainage device' , 'glaucoma drainage implants' , 'glaucoma filtration implants' , 'aqueous shunts' , 'uveitic glaucoma' , 'inflammatory glaucoma' . Result: A total of 143 articles were retrieved, but only 14 articles were eligible for data extraction. There are 631 eyes from 583 patients who had UG, 442 eyes underwent GDD implantation. Overall, intraocular pressure and the use of glaucoma medication were reduced. Mean IOP preoperative is 31.57 mmHg, and IOP postoperative is 14.48 mmHg. There is a reduction in IOP of an average of 17.09 mmHg. The number of glaucoma medications has decreased from 3.24 to 1.29 postoperatively. Conclusion: UG has been shown to be managed successfully by GDD implantation. GDD implantation may be considered a long-term effective surgical option for patients with UG.

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“…A AV corrigida com notação em Snellen foi convertida no logaritmo do ângulo mínimo de resolução (logarithm of the Minimum Angle of Resolution, logMAR). Para um AV inferior a 20/400, as equivalências em logMAR foram as seguintes: contagem de dedos (CD) = 1,98; movimentos da mão (MM) = 2,28; percepção luminosa (PL) = 2,80 72,73 . O registro de sem percepção luminosa (SPL) foi convertido a um valor de 2,9 74 .…”

Section: Medidas Da Acuidade Visualunclassified

Glaucoma em pacientes com aniridia e ceratoprótese de Boston tipo 1

Silva¹

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Silva RN. Glaucoma in patients with aniridia and Boston type 1 keratoprosthesis [thesis]. São Paulo: "Faculdade de Medicina, Universidade de São Paulo"; 2019. PURPOSE:To compare outcomes related to glaucoma and glaucoma management in eyes with aniridia after Boston Keratoprosthesis (B-KPro) type 1 implantation. METHODS: Eyes with titanium backplate B-KPro type 1 implanted between October 2007 and December 2015 at Massachusetts Eye and Ear, Boston, United States, with more than 2 years of follow-up, were retrospectively studied. Chart data was reviewed for patients with aniridia and patients with other preoperative diagnoses (excluding Stevens-Johnson syndrome, mucous membrane pemphigoid, and congenital ocular disorders with angle distortion). One eye per patient was selected by the longest followup time. The normality of continuous variables was assessed with the Shapiro-Wilk test. T test was used to compare normally distributed continuous variables and Wilcoxon rank-sum test for non-normally distributed variables. The Pearson chi-square test was used to compare categorical variables between groups. RESULTS: The groups aniridia (n = 22) and comparative (n = 61) had similar follow-up time (mean ± standard deviation; 70.7 ± 28.6 months; 63.8 ± 25.5 months, respectively, p = 0.25) and preoperative visual acuity (VA, 1.85 ± 0.35 logMAR; 1.87 ± 0.57 logMAR; p = 0.33). Prior to B-KPro surgery, aniridic eyes showed higher rates of glaucoma diagnosis (76.2%) and glaucoma surgery (57.1%) compared to the second group (51.8%, p = 0.053; 23.2%, p = 0.005, respectively). There was more co-implantation of glaucoma drainage devices concomitantly with B-KPro in aniridia (47.6%) versus comparison eyes (17.9%, p = 0.008). At the final follow-up visit, more eyes with aniridia had glaucoma (90.5%) and at least one glaucoma surgery before, during, or after B-KPro implantation (90.5%), than comparison eyes (64.3%, p = 0.02; 53.6%, p = 0.003). However, both obtained similar rates of cup to disc ratio (CDR) > 0.8 (23.8% vs. 30.4%, p = 0.57) or progression of CDR ≥ 0.2 (42.9% vs. 44.6%, p = 0.89). None of the eyes with prophylactic tube developed glaucoma. The percentages of eyes with at least one serious vision threatening complication were 45.5% in the aniridia group versus 26.2% in the comparative group (p = 0.10). Despite this, the two groups had similar percentages of eyes with VA improvement (72.7%, 72.1%, p = 0.96), and similar postoperative VA at the end of follow-up (1.28 ± 0.79 logMAR, 1.23 ± 0.98 logMAR, p = 0.51). CONCLUSIONS: Despite a high prevalence of glaucoma and other vision threatening complications, B-KPro type 1 surgery can lead to long-term visual rehabilitation in patients with aniridia when a team of trained specialists is available to manage glaucoma and other complications.

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A retrospective study on the outcomes of Ahmed valve versus Ahmed valve combined with fluocinolone implant in uveitic glaucoma

Cited by 10 publications

References 29 publications

Response to: Combined Dexamethasone Intravitreal Implant and Glaucoma Drainage Device Placement for Uveitic Glaucoma

Response to: Combined Dexamethasone Intravitreal Implant and Glaucoma Drainage Device Placement for Uveitic Glaucoma

Glaucoma drainage devices implantation in uveitic glaucoma: a systematic review

Glaucoma em pacientes com aniridia e ceratoprótese de Boston tipo 1

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