Management of implant plate exposure of silicone Ahmed glaucoma valve: a review of six cases

Roy, Aravind; Senthil, Sirisha

doi:10.3205/oc000047

Cited by 4 publications

(2 citation statements)

References 8 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have observed that once a major part of the implant body is exposed, it may be advisable to remove the implant rather than attempting to close it, as chances for necrosis and re-exposure remain very high. [ 26 ] After successful explanation of the implants, as expected, the IOP went up significantly in all the eyes (mean = 31.6 (+/−6.9), range = 23–40, in mm Hg)—even after restarting maximal antiglaucoma medications—that needed a repeat filtering procedure. In the largest published cohort of six eyes, Smith et al .…”

Section: Discussionsupporting

confidence: 62%

Outcomes of reimplantation of a new Glaucoma Drainage Device after explantation of an older implant from exposure-related complications

Yaswanth,

Roy,

Senthil

et al. 2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: To describe the clinical outcome of a series of seven eyes with an explanation of an original Glaucoma Drainage Device (GDD) arising from the complication of plate exposure and consequent reimplantation of another GDD at a second setting. Methods: This was a retrospective, interventional, and non-comparative study at two tertiary eye care hospitals in eastern and southern India. Electronic medical record data of the seven eyes where a GDD was explanted and a 2nd GDD was reimplanted over October 2010 and May 2021 was analyzed. Statistical analysis was done by SPSS (ver. 26). Results: The first GDD survived for a mean of 168 days only till the plate got exposed and thereby got explanted. Possible predisposing factors noted were conjunctival and scleral thinning, ischemic conjunctiva, etc., The reimplantation surgery was technically easy in the absence of hypotony—opposite to what is reported in the literature. The final IOP (mean +/− SD) values (mm Hg) were 18.9 (+/−7.9), range = 10–30. The mean number of glaucoma medications reduced from 3.9 (+/−1.2; range, 2 to 5) after the explanation to 3.1 (+/−0.7; range, 2 to 4) after the 2nd GDD implantation, in the final follow-up. The second GDD was found to be stable till the last follow-up (mean = 1149 days). No other significant intraoperative or postoperative complications were seen. Conclusions: Reimplantation of a second GDD in a separate setting after explanations of an original implant due to exposure-related complication is both a safe and effective method.

show abstract

Section: Discussionsupporting

confidence: 62%

Outcomes of reimplantation of a new Glaucoma Drainage Device after explantation of an older implant from exposure-related complications

Yaswanth,

Roy,

Senthil

et al. 2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…24 Local ischemia and excessive implant mobility were identified to be the causes of late plate exposure (>3 months post-operatively). 28 Previous ocular surgery was identified as a significant risk factor for GDD implant exposure. 29 There are several limitations in our study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Short and Long-Tunnel Needle Track for Ahmed Glaucoma Valve Implantation in a Private Eye Center in the Philippines: A Retrospective Study

Pedro¹,

Gomez²,

Leuenberger³

2023

OPTH

View full text Add to dashboard Cite

Purpose This study aimed to compare the success and complication rates among patients implanted with Ahmed Glaucoma Valve (AGV) using the short and long tunnel technique through retrospective chart review. Patients and Methods We reviewed 54 charts of adult patients who underwent AGV implantation using a Short-Needle Track (SNT) or Long-Needle Track (LNT) technique. Intraocular pressures (IOP), Best Corrected Visual Acuity (BCVA) and number of medications were recorded pre-operatively, and at Day 1, 3, 7, Month 1, 3, 6 post-operatively. Treatment success, occurrence of Hypertensive Phase (HP), complication and procedures done after AGV implantation were compared between the two groups using one-tailed Z-test of proportions. Results A total of 20 (LNT) and 21 (SNT) charts were included in the study. There was no significant difference between the median postoperative IOP, BCVA, and number of anti-glaucoma medications between the two groups at each time interval. The comparison between the occurrence of HP (P = 0.435) and success rates (P = 0.476) between the two groups yielded no significant difference. Flat/shallow anterior chamber (AC) was seen exclusively in three eyes (14%) in the SNT group (P = 0.039). There was one occurrence of plate exposure in the LNT group (P = 0.149). Conclusion The LNT technique of AGV Implantation may be used as an alternative to the traditional SNT (with autologous graft). The long needle track offers the advantage reducing the risk of complications arising from shallow anterior chamber post-operatively.

show abstract

Unusual sequelae of staphyloma following Ahmed glaucoma valve explantation and its management

2021

View full text Add to dashboard Cite

We report a case of a 7-year-old boy, who presented with plate exposure after Ahmed glaucoma valve (AGV) implantation in the eye with secondary glaucoma following penetrating trauma. He underwent AGV explantation with scleral patch graft and conjunctival limbal autograft and started on topical and oral antiglaucoma medication (AGM) for intraocular pressure (IOP) control. Two months later, he presented to us with high intraocular pressure and uveal tissue prolapse at the site of previous tube entry displacing the scleral and conjunctival grafts posteriorly. The defect was closed with corneal patch graft. Patient underwent limited transscleral cyclophotocoagulation and was maintained on topical AGM for IOP control. Our case highlights that explantation is a definitive management in such cases of plate exposure. Tube entry site is a potential weak area and there is risk of uveal prolapse through this area with high IOP. Corneal patch graft helps in successfully managing such defects involving the sclero-limbal region.

show abstract

Management of implant plate exposure of silicone Ahmed glaucoma valve: a review of six cases

Cited by 4 publications

References 8 publications

Outcomes of reimplantation of a new Glaucoma Drainage Device after explantation of an older implant from exposure-related complications

Outcomes of reimplantation of a new Glaucoma Drainage Device after explantation of an older implant from exposure-related complications

Comparison of Short and Long-Tunnel Needle Track for Ahmed Glaucoma Valve Implantation in a Private Eye Center in the Philippines: A Retrospective Study

Unusual sequelae of staphyloma following Ahmed glaucoma valve explantation and its management

Contact Info

Product

Resources

About