Articles Vol. 63 No. 1 (2022) 06/01/2022

CLINICAL OUTCOMES OF AHMED GLAUCOMA VALVE IMPLANTATION FOR REFRACTORY GLAUCOMA FOLLOWING PARS PLANA VITRECTOMY

Nguyen Thi Thu Tam1,2, Pham Thi Thuy Tien3,4, Ngo Thanh Tung3,4, Le Minh Tuan1,2
1 University of Medicine and Pharmacy of HCMC
2 Đại học Y Dược TP HCM
3 Eye Hospital HCMC
4 Bệnh viện Mắt TP HCM
Corresponding author: thutamnguyenmd@gmail.com
DOI: 10.52163/yhc.v63i1.259
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Keywords
Ahmed glaucoma valve, secondary glaucoma post vitrectomy.
Abstract

Purpose: To evaluate the early effectiveness of Ahmed valve glaucoma for refractory glaucoma following pars plana vitrectomy.

Methods: Noncomparative interventional case series. In this study, we analyzed the medical records of patients at Ho Chi Minh Eye Hospital, from July 2019 to February 2020. All patients suffering from secondary glaucoma following pas plana vitrectomy and IOP could not be controlled with maximum anti-glaucoma drugs (3 agents) for at least 2 weeks were implemented with Ahmed glaucoma valve implantation. Patients were evaluated at 1 day, 1 month, 3 months, 6 months and each 3 months post-operatively until the end of study.

Results: Thirty-four eyes of 33 patients with a mean age of 46.71 ± 14.40 years underwent a AGV implantation. The average follow-up after surgery was 11.49 ± 4.99 months (range 6-24 months). On average, treatment reduced the IOP by 15.4 ± 7.4 mmHg at the last visit. Kaplan–Meier survival analysis revealed cumulative success of 97.1%  at 3 months, 94.1% at 4 months, 91.2% at 6 months, 87.5% at 9 months and still stable until 24 months. Vision-threatening complications did not recorded. The success rate was 88,23%. Cause of failure was high IOP due to bleb encapsulation. Totally, 11.76% of patients had decreased in vision acuity. Factors including hypertensive phase, bleb encapsulation and high preoperative IOP were found to be associated with higher failure rates.

Conclusions: Ahmed valve implantation is a safe and effective method for refractory glaucoma following vitrectomy.

References
[1]
Aken EV, Haeghen YV, Lemij H et al., Baerveldt glaucoma implants in the management of refractory glaucoma after vitreous surgery, Acta Ophthalmol., 2010, 88, pp. 75-79. Google Scholar
[2]
Barton K, Feuer WJ, Budenz DL et al., Five-Year Treatment Outcomes in the Ahmed Baerveldt Comparison Study, Ophthalmology, 2015, 122(2), pp. 308-316. Google Scholar
[3]
Coleman AL, Hill R, Wilson MR et al., Initial Clinical Experience With the Ahmed Glaucoma Valve Implant, American journal of ophthalmology, 1995, 120(1), pp. 23-31. Google Scholar
[4]
Cheng Y, Shen X, Liu XH et al., Ahmed valve implantation for neovascular glaucoma after 23-gauge vitrectomy in eyes with proliferative diabetic retinopathy, International journal of ophthalmology, 2013, 6(3), pp. 316-20. Google Scholar
[5]
Erçalık NY, ˙Imamo˘glu S, Ahmed Glaucoma Valve Implantation in Vitrectomized Eyes, Journal of Ophthalmology, 2018, pp. 1-5. Google Scholar
[6]
Fang Y, Wang X, Long Q et al., Intraocular pressure 1 year after vitrectomy in eyes without a history of glaucoma or ocular hypertension, Clin Ophthalmol, 2017, 11, pp. 2091-2097. Google Scholar
[7]
Gupta S, Chaurasia A, Chawla R et al., Long-term outcomes of glaucoma drainage devices for glaucoma post-vitreoretinal surgery with silicone oil insertion: a prospective evaluation, Graefe's Archive for Clinical and Experimental Ophthalmology, 2016, 254(12), pp. 2449-2454. Google Scholar
[8]
Han PD, Lambrou HF, Lewis H et al., Mechanisms of Intraocular Pressure Elevation after Pars Plana Vitrectomy, Ophthalmology, 1989, 96(9), pp. 1357-1362. Google Scholar
[9]
Henderer JD, Disc damage likelihood scale, The British journal of ophthalmology, 2006, 90(4), pp. 395-396. Google Scholar
[10]
Hong JW, Choi GJ, Ahmed Valve Implantation for Refractory Glaucoma following Pars Plana Vitrectomy, Korean journal of ophthalmology: KJO, 2005, 19, pp. 293-296. Google Scholar
[11]
Ishida K, Ahmed II, Netland PA, Ahmed Glaucoma Valve Surgical Outcomes in Eyes With and Without Silicone Oil Endotamponade, Journal of glaucoma, 2009, 18(4), pp. 325-330. Google Scholar
[12]
Jo J, Sung KR, Kim YJ, Influence of Vitrectomy-related Factors on the Outcome of Ahmed Glaucoma Valve Implantation, Korean Journal of Ophthalmology, 2018, 32(5), pp. 400-408. Google Scholar
[13]
Jeong HJ, Park CK, Park HY, Effects of Early Postoperative Intraocular Pressure after Ahmed Glaucoma Valve Implantation on Long-term Surgical Outcomes, Korean J Ophthalmol., 2018, 32(5), pp. 391–399. Google Scholar
[14]
Jung KI, Park CK, Woo JE, Effects of aqueous suppressants and prostaglandin analogues on early wound healing after glaucoma implant surgery, Scientific Reports, 2019, 9, pp. 1-10. Google Scholar
[15]
Lee J, Park CK, Jung KI, Initial Glaucoma Medication in the Hypertensive Phase Following Ahmed Valve Implantation: A Comparison of Results Achieved Using Aqueous Suppressants and Prostaglandin Analogs, J Clin Med., 2020, 9(2), pp. 416-428 Google Scholar
[16]
Qian Z, Xu K, Kong X et al., Ahmed Glaucoma Valves versus EX-PRESS Devices in Glaucoma Secondary to Silicone Oil Emulsification, Journal of Ophthalmology, 2018, pp. 1-7. Google Scholar