Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Schimiti, Rui Barroso; Abe, Ricardo Y.; Tavares, Carla Melo; Vasconcellos, José Paulo Cabral de; Costa, Vital Paulino

doi:10.5005/jp-journals-10008-1209

Cited by 12 publications

(13 citation statements)

References 41 publications

(49 reference statements)

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“…Previous studies demonstrating the success rates of initial AGVs yielded similar results. eir cumulative success rates ranged from 75.0% to 87.0% at one year, 60.6% to 75.0% at two years, and 54.0% to 66.0% at three years [2,[23][24][25][26][27]. Despite being a second AGV implantation, our success rates are comparable to that of initial AGVs in current literature.…”

Section: Discussionsupporting

confidence: 55%

Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

Ong

Aquino

Chew

et al. 2020

Journal of Ophthalmology

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Introduction. When the initial glaucoma tube shunt fails in eyes with refractory glaucoma, one option is implantation of an additional Ahmed glaucoma valve (AGV) to control intraocular pressure (IOP). We aim to evaluate the outcomes of a second AGV in Asian glaucoma. Material and Methods. This is a retrospective interventional study, consisting of 21 eyes belonging to 20 patients which underwent a second FP7 AGV. Data collected included demographic characteristics, best corrected visual acuity, IOP, and number of medications. Both intraoperative and postoperative complications or interventions were recorded. The primary outcome measurement was success rate: complete success (IOP ≥5 mmHg and ≤21 mmHg without IOP-lowering medications) and qualified success (IOP ≥5 mmHg and ≤21 mmHg with IOP-lowering medications). Failure was defined as IOP ≥5 mmHg and ≤21 mmHg, reoperations for IOP-related indications, removal of second AGV implant, or loss of light perception. Postoperative complications were included as secondary outcomes. Results. The cumulative failure rates were 9.5%, 20.0%, 32.5%, and 46.0% at six months, one year, two years, and three years of follow-up. At final follow-up, complete success and qualified success rates were 23.8% and 33.3%, respectively; mean IOP and number of medications decreased by 5.6 mmHg (23.9%) and 1.7 mmHg (54.8%), respectively, from preoperative baseline (P<0.01). More common postoperative complications included hypertensive phase (38.1%), corneal decompensation (23.8%), and tube exposure (14.3%). Conclusion. An additional AGV implant had good short and modest long-term effectiveness in reducing IOP following a failed glaucoma tube shunt in Asian eyes, with the mentioned common postoperative complications to be actively monitored and managed.

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Section: Discussionsupporting

confidence: 55%

Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

Ong

Aquino

Chew

et al. 2020

Journal of Ophthalmology

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“…hypertensive phase, shallow anterior chamber, and choroidal detachment) is roughly the same as with the already mentioned procedures. 27 Thus, in case of expected scarring or to avoid severe complications, nontransconjunctival minimally invasive approach like MIGS might be a promising alternative.…”

Section: Discussionmentioning

confidence: 99%

“…hypertensive phase, shallow anterior chamber, and choroidal detachment) is roughly the same as with the already mentioned procedures. 27…”

Section: Discussionmentioning

confidence: 99%

iStent inject as a reasonable alternative procedure following failed trabeculectomy?

Davids

Pahlitzsch

Boeker

et al. 2018

European Journal of Ophthalmology

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Minimal invasive glaucoma surgery (iStent inject) can offer an effective intraocular pressure reduction in advanced adult primary and secondary open angle glaucoma after failed trabeculectomy in a follow-up period of 1 year. Glaucoma therapy, however, needs to be maintained to achieve an individual target pressure and to prevent glaucoma progression. In addition, a failure rate of 27.3% makes it necessary to select carefully patients for this treatment option.

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“…Its efficacy is proved in Laser Glaucoma study, 18 Early manifest Glaucoma trial 19 and Advanced glaucoma intervention study. 20 Laser peripheral Iridoplasty flattens the peripheral hump of iris, widens the angle in all patients with narrow occludable angles after LPI and changes were maintained till 03 months follow-up. Still its efficacy in PAC stays controversial.…”

Section: Discussionmentioning

confidence: 80%

Role of Anterior Segment OCT in the Management of Primary Narrow Angle Disease

Muid¹,

Farooq²

2020

pak J Ophthalmol

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Purpose: To highlight the role of anterior segment OCT, in complementing gonioscopic findings in the management of angle closure glaucoma. Study Design: Descriptive observational case series. Study Place and Duration: Study was conducted at Eye department of Shifa International Hospital, from January 2019 to March 2019. Methods: After taking informed consent from the patients, the study was conducted at Shifa International Hospital Islamabad. Patients were selected by convenient sampling technique. Patients were diagnosed on the basis of history and clinical examination. Patients with angle closure on Gonioscopy were included in this series. Detailed ocular examination including visual acuity for distance and near, tonometry, Gonioscopy and anterior segment OCT were performed. Data was collected and presented as case series. Results: The median age 57 years with 50% more than 60 years and 50% less than 60 years of age. Presenting IOP was less than 21 mmHg in 50% and higher in remaining 50%. On examination 37.5% were categorized as PACS, 12.5% having PAC and 50% as PACG. After definitive treatment 12.5% still needed medical treatment to prevent progression in PACG and none in PACS and PAC. Conclusion: In narrow angle disease, treatment is designed not only to control intraocular pressure (IOP) but also to keep angle open as much as possible. Appositional closure or peripheral anterior synechiae (PAS) can damage the trabecluar meshwork. Iridoplasty, peripheral Iridotomy (PI) and early lens extraction can defer the need for filtration procedure if done well in time. Key Words: OCT anterior segment, Narrow angle, Optic nerve head.

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Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Cited by 12 publications

References 41 publications

Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

Surgical Outcomes of a Second Ahmed Glaucoma Valve Implantation in Asian Eyes with Refractory Glaucoma

iStent inject as a reasonable alternative procedure following failed trabeculectomy?

Role of Anterior Segment OCT in the Management of Primary Narrow Angle Disease

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