Flexible Ahmed Valve for Selected Cases of Refractory Glaucoma

Mokbel, Tharwat H; Khalaf, Mohamed A.; Elkhouly, Sherief; El-Metwally, Nasser O.

doi:10.5301/ejo.5000003

Cited by 4 publications

(3 citation statements)

References 10 publications

(11 reference statements)

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“…The Ahmed Baerveldt Comparison Study stated a rate of 19% [17], but Choo's study reported a value of only 2.63% [18]. Intraoperatively injecting the appropriate volume of viscoelastics to deepen the anterior chamber is crucial to reduce the rate of postoperative flat anterior chamber [19,20]. The anterior chamber did not exhibit recurrence of shallowing in these four cases after a single surgical intervention.…”

Section: Discussionmentioning

confidence: 87%

Surgical outcomes of Ahmed glaucoma valve implantation in patients with glaucoma secondary to iridocorneal endothelial syndrome

Mao

Guo²,

Zhong

et al. 2020

Eye

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Objectives To evaluate the long-term outcome of patients with iridocorneal endothelial (ICE) syndrome who underwent Ahmed glaucoma valve implantation surgery for uncontrolled glaucoma. Methods Eighteen patients who suffered from unilateral ICE syndrome with uncontrolled glaucoma and subsequently underwent Ahmed aqueous shunt surgery at Zhongshan Ophthalmic Center between January 2008 and December 2016 were reviewed. Outcome measures included intraocular pressure (IOP), the use of glaucoma medications, visual acuity, further surgical interventions, and surgical complications. Results The mean IOP was reduced from 34.8 ± 10.6 mmHg on 3.6 ± 0.5 medications to 17.4 ± 4.9 mmHg (t = 6.791, P = 0.000) on 1.6 ± 1.1 medications (Z = −3.545, P = 0.000) at the last follow-up (42.0 ± 19.3 months). Five eyes (27.8%) achieved complete success, nine (50.0%) achieved qualified success, and the remaining four (22.2%) were considered failures. Survival was 94.4% at 1 year, 88.1% at 2 years, and 73.5% at 3 years. Four cases displayed a flat anterior chamber and were treated with a single anterior chamber reformation surgery with no recurrence. No other complications related to the glaucoma drainage implants occurred in this series. Conclusions Ahmed glaucoma valve implantation appears to be a safe and effective method for treating glaucoma secondary to ICE syndrome. Postoperative shallow anterior chamber and hypotony may occur but responds well to the treatment. Early consideration may be given to aqueous shunt surgery in patients with glaucoma secondary to ICE syndrome when trabeculectomy fails.

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Section: Discussionmentioning

confidence: 87%

Surgical outcomes of Ahmed glaucoma valve implantation in patients with glaucoma secondary to iridocorneal endothelial syndrome

Mao

Guo²,

Zhong

et al. 2020

Eye

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“…These results are similar to the results Ishida et al [21] reported: a 94.2% success rate with FP7 implant at 12 months. In 40 eyes from 40 patients with different types of refractory glaucoma, a 92.5% success rate was reported with both FP7 and FP8 after a follow-up period of 6 months [22]. Unfortunately, this study did not report separate success rates between FP7 and FP8 groups.…”

Section: Discussionmentioning

confidence: 92%

Comparison of the Outcome of Silicone Ahmed Glaucoma Valve Implantation with a Surface Area between 96 and 184 mm²in Adult Eyes

Koh

Hwang

Jung

et al. 2013

Korean J Ophthalmol

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PurposeTo compare the success rates, complications, and visual outcomes between silicone Ahmed glaucoma valve (AGV) implantation with 96 mm2 (FP8) or 184 mm2 (FP7) surface areas.MethodsThis study is a retrospective review of the records from 132 adult patients (134 eyes) that underwent silicone AGV implant surgery. Among them, the outcomes of 24 eyes from 24 patients with refractory glaucoma who underwent FP8 AGV implantation were compared with 76 eyes from 76 patients who underwent FP7 AGV implantation. Preoperative and postoperative data, including intraocular pressure (IOP), visual acuity, number of medications, and complications were compared between the 2 groups.ResultsThere were no significant differences in baseline characteristics between the 2 groups (p > 0.05). The postoperative visual acuity of the patients in the FP8 group was better than that of the patients in the FP7 group in some early postoperative periods (p < 0.05); however, after 10 postoperative months, visual acuity was not significantly different through the 3-year follow-up period (p > 0.05). Postoperative IOP was not significantly different between the 2 groups (p > 0.05) except for IOP on postoperative day 1 (11.42 mmHg for the FP7 group and 7.42 mmHg for the FP8 group; p = 0.031). There was no statistical difference in success rates, final IOP, number of medications, or complication rates between the 2 groups (p > 0.05).ConclusionsThe FP7 and FP8 AGV implants showed no difference in terms of vision preservation, IOP reduction, and number of glaucoma medications required.

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“…[11][12][13] Glaucoma drainage devices are also used to treat PCG. 14,15 The use of antimetabolites eg 5-fluorouracil and mitomycin C reduces scarring and increases the success rates. 16 Non-penetrating deep sclerectomy (NPDS) is another alternative where the surgeon elevates a partial thickness scleral flap and removes the external portion of Schlemm's canal together with the outer part of the trabecular meshwork including the juxtacanalicular tissue without full penetration inside the eye.…”

Section: Introductionmentioning

confidence: 99%

<p>Non-Penetrating Deep Sclerectomy versus Trabeculectomy in Primary Congenital Glaucoma</p>

Elhofi¹,

Helaly²

2020

OPTH

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Purpose: To evaluate the safety and efficacy of non-penetrating deep sclerectomy with a collagen implant versus trabeculectomy in primary congenital glaucoma. Subjects and Methods: This was a retrospective interventional comparative nonrandomized clinical study that included 80 eyes of 80 children presenting with primary congenital glaucoma under the age of 3 years. Forty eyes have undergone non-penetrating deep sclerectomy (NPDS) and the other 40 eyes have undergone penetrating trabeculectomy. The main outcome measure was the reduction in intraocular pressure (IOP). Secondary outcomes included percentage of patients with complete and qualified success, need for topical antiglaucoma medications, rate of complications, and need for further interventions. Complete success of the surgical outcome was considered an IOP ≤16 mmHg with no antiglaucoma medications. Qualified success was considered an IOP ≤16 mmHg using antiglaucoma medications. Results: The mean preoperative IOP was 27.4 ± 6.9 and 28.5 ± 6.6 mmHg in NPDS and trabeculectomy groups, respectively (p = 0.175). At the end of the follow-up period, the mean IOP was 11.2 ± 4.5 and 11.1 ± 3.4 mmHg with a mean reduction of 16.2 and 17.4 mmHg in NPDS and trabeculectomy groups, respectively. At the end of the follow-up period, ie at 36 months postoperative, the complete success rate was 60% (24 eyes) versus 57.5% (23 eyes), the qualified success rate was 25% (10 eyes) versus 25% (10 eyes), the overall success rate was 85% (34 eyes) versus 82.5% (33 eyes), and the rate of failure was 15% (6 eyes) versus 17.5% (7 eyes) in NPDS and trabeculectomy groups, respectively (p = 0.952). Eight cases (20%) of the trabeculectomy group had shallow anterior chamber. None of the NPDS group cases suffered from shallow anterior chamber. Conclusion: Non-penetrating deep sclerectomy appears to be an efficient and safe surgical alternative to penetrating trabeculectomy in treatment of primary congenital glaucoma. Nonpenetrating deep sclerectomy has fewer postoperative complications in comparison to penetrating trabeculectomy with a comparative postoperative reduction in the intraocular pressure and overall success rates. Trial Registration: The trial was registered on 11/01/2020 with number PACTR202002874953456 (https://pactr.samrc.ac.za).

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Flexible Ahmed Valve for Selected Cases of Refractory Glaucoma

Abstract: Flexible Ahmed glaucoma valve plate implant is a satisfactory method for controlling elevated IOP in cases of refractory glaucoma with success rate of 92.5% and lower incidence of immediate postoperative and implant-related complications.

Cited by 4 publications

References 10 publications

Surgical outcomes of Ahmed glaucoma valve implantation in patients with glaucoma secondary to iridocorneal endothelial syndrome

Surgical outcomes of Ahmed glaucoma valve implantation in patients with glaucoma secondary to iridocorneal endothelial syndrome

Comparison of the Outcome of Silicone Ahmed Glaucoma Valve Implantation with a Surface Area between 96 and 184 mm²in Adult Eyes

<p>Non-Penetrating Deep Sclerectomy versus Trabeculectomy in Primary Congenital Glaucoma</p>

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Flexible Ahmed Valve for Selected Cases of Refractory Glaucoma

Abstract: Flexible Ahmed glaucoma valve plate implant is a satisfactory method for controlling elevated IOP in cases of refractory glaucoma with success rate of 92.5% and lower incidence of immediate postoperative and implant-related complications.

Cited by 4 publications

References 10 publications

Surgical outcomes of Ahmed glaucoma valve implantation in patients with glaucoma secondary to iridocorneal endothelial syndrome

Surgical outcomes of Ahmed glaucoma valve implantation in patients with glaucoma secondary to iridocorneal endothelial syndrome

Comparison of the Outcome of Silicone Ahmed Glaucoma Valve Implantation with a Surface Area between 96 and 184 mm2in Adult Eyes

<p>Non-Penetrating Deep Sclerectomy versus Trabeculectomy in Primary Congenital Glaucoma</p>

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Comparison of the Outcome of Silicone Ahmed Glaucoma Valve Implantation with a Surface Area between 96 and 184 mm²in Adult Eyes