Surgical outcomes associated with a sutureless drainage valve implantation procedure in patients with refractory glaucoma

Pham, Caroline N; Radcliffe, Nathan M.; Vu, Daniel M.

doi:10.2147/opth.s186369

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…Pham et al performed sutureless AGV implantation using a pericardial patch graft instead of sutures, either alone or combined with other operations. The IOP reduction, number of medications required, and complication rate were similar to those of previous studies on tube shunt implantation [19]. In our study, the postoperative IOPs at 2 years were 16.4 ± 3.8 and 15.7 ± 4.8 mmHg in the CAGV and FPAGV groups, respectively.…”

Section: Discussionsupporting

confidence: 89%

Clinical outcomes of Ahmed glaucoma valve implantation without fixation of a plate: The free plate technique

et al. 2020

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Objective This study compared surgical outcomes between free plate Ahmed glaucoma valve (FPAGV) implantation without plate fixation and conventional Ahmed glaucoma valve (CAGV) implantation with plate fixation. Methods A retrospective, comparative case series study. Patients with refractory glaucoma who underwent FPAGV or CAGV implantation and were followed >1 year were enrolled consecutively. We reviewed medical records, including data on postoperative intraocular pressure (IOP) and postoperative complications. The success rate and early postoperative hypertensive phase were compared between groups. Results A total of 74 patients with CAGV implantations and 36 patients with FPAGV implantations were studied. The average follow-up periods were 23.3 ± 2.6 months (CAGV) and 22.8 ± 2.8 months (FPAGV; p = 0.424). The surgery time was significantly shorter in the FPAGV group than in the CAGV group (42.6 ± 4.1 vs. 47.3 ± 5.4 min; p < 0.001). Postoperative IOP at 1 week and 1 month were significantly lower in the FPAGV group than in the CAGV group (11.8 ± 3.6 and 14.0 ± 5.3 mmHg vs. 18.7 ± 5.5 and 22.2 ± 5.2 mmHg; p = 0.012 and p = 0.002, respectively). An early postoperative hypertensive phase occurred in 62 eyes, and the frequency was greater in the CAGV group (50 eyes) than the FPAGV group (12 eyes; p = 0.001). There was no significant difference in postoperative complications between the two groups (p = 0.735). The success rate was 84.2% in the FPAGV group and 80.6% in the CAGV group 24 months after surgery (p = 0.367). Conclusion FPAGV implantation was associated with a shorter surgery time, without any change in the extent of IOP reduction or complication rate. This procedure may be considered a good alternative for CAGV implantation in patients with refractory glaucoma.

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Section: Discussionsupporting

confidence: 89%

Clinical outcomes of Ahmed glaucoma valve implantation without fixation of a plate: The free plate technique

et al. 2020

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“…8 That technique was used for our group of patients in which no sutures were used to fixate the plate. Other authors have proposed replacing suturing with fibrin glue, such as with the fibrin sealant Tisseel, as described by Pham et al 9 There was a high percentage of complications and failures in both of the current study groups, the most common of which was AGV migration. Complications and failures were somewhat higher in the vicryl fixation group, but there were no significant differences in the surgical results (IOP, number of antiglaucoma medications, BCVA) between the two groups.…”

Section: Discussionmentioning

confidence: 66%

Surgical outcomes of Ahmed glaucoma valve implantation with plate fixation using vicryl sutures or no plate fixation

Singer

Kapelushnik

Rotenstreich

et al. 2021

European Journal of Ophthalmology

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Purpose: To summarize the surgical outcomes of Ahmed glaucoma valve (AGV) implantation with plate fixation with vicryl absorbable sutures or no plate suturing. Methods: This study was a retrospective case series that included all glaucoma patients who underwent AGV implantation surgery with vicryl absorbable sutures for plate fixation or without plate fixation by a single surgeon between 2014 and 2019. We reviewed their medical records and retrieved clinical data on intra- and postoperative complications, best-corrected visual acuity, intraocular pressure (IOP), and number of IOP-lowering medications. Results: Twenty out of 29 eyes (29 patients, mean age 61.04 ± 27.1 years, 17 men) underwent AGV implantation without plate fixation and nine had AGV implantation with fixation with vicryl sutures. Complications were observed in 15 cases (51.7%). Nine of these were defined as failure due to the need for removal or repositioning of the AGV or for further surgery for uncontrolled IOP, of which five were no-fixation cases (5/20, 25%) and four were vicryl-fixation cases (4/9, 44.4%). Six of all surgical failures were related to AGV migration (6/9, 66.6%). There were three cases of extrusion and one case of plate migration in the no-fixation group, and two cases of plate migration and one case of extrusion in the vicryl-fixation group. Conclusion: AGV implantation without suture plate fixation or with vicryl suture fixation had a high complication and failure rate, often necessitating reoperation and AGV removal. The high rate of tube-related complications observed after both techniques does not favor either of them. The use of non-absorbable sutures for suturing of the AGV plate is recommended.

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“…Sanvicente et al8 suggested positioning the plate posterior to the globe equator, relying on globe anatomy to provide stability and resist migration of the plate. Pham et al12 used limited dissection to create an undersized Tenon pocket that would hold the plate placed >8 mm posterior to the limbus, and a 5 mm long scleral tunnel designed to hold the tube in place. In their attempt to omit any suturing, the conjunctiva was sealed with Tisseel fibrin sealant in place of sutures.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Ahmed Glaucoma Valve Implantation Without Plate Sutures: A 10-Year Retrospective Study

Kapelushnik

Singer

Barkana

et al. 2021

Journal of Glaucoma

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Précis: Ahmed glaucoma valve (AGV) implantation without plate fixation resulted in high rates of complications related to plate or tube movement.Purpose: Scleral suturing of the plate of AGV is associated with technical difficulty and potential complications. This study summarizes the surgical outcomes of 10 years of experience with AGV implantation without suture plate fixation. Methods:The medical records of all glaucoma patients who underwent AGV implantation surgery without plate fixation between 2009 and 2019 at the Sheba Medical Center (Tel Hashomer, Israel) were retrospectively reviewed. Clinical data on intraoperative and postoperative complications, best-corrected visual acuity, intraocular pressure, and number of intraocular pressure-lowering medications were retrieved.Results: Included were 95 eyes of 95 patients (53 men, 42 women; mean age, 54.9 ± 17.5 y). The mean follow-up was 687 ± 673 days. In total, 37 patients (37/95, 38.%) had AGV-related complications, of whom 28 (29.5%) required additional intervention. Women had a significantly higher rate of complications than men (21/42, 50% vs. 16/53, 30.2%, respectively, P = 0.049). The 2 most common complications were AGV migration in 13 eyes (13.7%) and tube exposure/AGV extrusion in 9 eyes (9.5%). AGV was removed in 10 cases.Conclusions: In this cohort, omitting suture AGV plate fixation resulted in high rates of complications related to plate or tube movement, the need for further intervention, and AGV removal. Therefore, we cannot recommend this surgical technique.

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Surgical outcomes associated with a sutureless drainage valve implantation procedure in patients with refractory glaucoma

Cited by 7 publications

References 23 publications

Clinical outcomes of Ahmed glaucoma valve implantation without fixation of a plate: The free plate technique

Clinical outcomes of Ahmed glaucoma valve implantation without fixation of a plate: The free plate technique

Surgical outcomes of Ahmed glaucoma valve implantation with plate fixation using vicryl sutures or no plate fixation

Surgical Outcomes of Ahmed Glaucoma Valve Implantation Without Plate Sutures: A 10-Year Retrospective Study

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