Non-intraocular pressure-related revision surgeries after Ahmed glaucoma valve (AGV) implantation in refractory glaucoma

2021 ◽  
Author(s):  
Asli Kirmaci Kabakci ◽  
Banu Solmaz ◽  
Berna Basarir ◽  
Burcu Kemer Atik ◽  
Tekin Yasar
Keyword(s):  
Intraocular Pressure ◽  
Ahmed Glaucoma Valve ◽  
Refractory Glaucoma

scholarly journals Intraluminal stenting versus external ligation of Ahmed glaucoma valve in prevention of postoperative hypotony

2021 ◽  
Vol 14 (10) ◽  
pp. 1560-1564
Author(s):  
Dina Abd Elfattah ◽  
◽  
Tharwat Mokbel ◽  
Hisham Elsorogy ◽  
Abd-Elmonem A. Elhesy ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Primary Outcome ◽  
Ahmed Glaucoma Valve ◽  
Refractory Glaucoma ◽  
Group 2 ◽  
One Year ◽  
Prevention Methods ◽  
Age Range ◽  
Group 1

AIM: To compare intraluminal stenting and external ligation of Ahmed glaucoma valves (AGV) for refractory glaucoma management and postoperative hypotony prevention. METHODS: This randomized prospective blind study included 30 eyes of 25 patients (age range: 44-56y) with refractory glaucoma. This study was conducted from September 2018 to January 2020. The study included two groups, AGV with intraluminal stenting group (n=15 eyes) and AGV with external ligation group (n=15 eyes). Follow-up period was one year postoperatively. The primary outcome was intraocular pressure (IOP) and its association with the number of postoperative glaucoma medications. IOP?≤?21 mm Hg without medications indicated complete success while IOP?≤?21 mm Hg with medications indicated qualified success; and IOP<6 mm Hg was defined as hypotony. RESULTS: After a year of follow-up, IOP was significantly reduced in the intraluminal stenting group than in the external ligation group (11.67±0.89 vs 14.2±4.0 mm Hg, respectively, P=0.024). Postoperative hypotony was more common in the external ligation group (2 cases, 13.33%) than in the intraluminal stenting group (1 case, 6.67%). CONCLUSION: Application of intraluminal stenting or external ligation during AGV surgery usually prevents postoperative hypotony (transient and persistent) that occurs in conventional AGV surgery.

scholarly journals Ologen augmentation of Ahmed glaucoma drainage devices in pediatric glaucomas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adam Jacobson ◽  
Carin Rojas ◽  
Brenda L. Bohnsack
Keyword(s):  
Intraocular Pressure ◽  
Pediatric Patients ◽  
Survival Rates ◽  
Collagen Matrix ◽  
Ahmed Glaucoma Valve ◽  
Limited Data ◽  
Conventional Surgery ◽  
Glaucoma Drainage Devices ◽  
Hypertensive Phase

Abstract Background Limited data exists on the effectiveness of the collagen matrix, Ologen, on increasing Ahmed glaucoma valve (AGV) success in childhood glaucomas. Methods Ocular examination and surgical details of pediatric patients who underwent AGV placement ± Ologen augmentation between 2012 and 2020. Complete success was defined as intraocular pressure (IOP) between 5 and 20 mmHg without glaucoma medications and additional IOP-lowering surgeries. Qualified success was defined as above, except IOP control maintained with or without glaucoma medications. Results Twenty-two eyes of 16 patients underwent AGV placement of which 6 eyes had Ologen-augmentation (OAGV) and 16 eyes had conventional surgery (CAGV). Average age was 6.4 ± 5.1 years with 4.2 ± 2.5 follow-up years. There was no difference in age, number of previous surgeries, and preoperative IOP and glaucoma medications. At final follow-up, success rate was 100% (5 eyes complete, 6 eyes qualified) in the OAGV group compared to 31% (0 eyes complete, 5 eyes qualified) in the CAGV group. One and two-year survival rates were 100% for OAGV compared to 62 and 38% for CAGV. Postoperative IOP was significantly lower at 1-month and final follow-up (p = 0.02) as was the number of glaucoma medications at 3, 6, 12-months and final follow-up (p < 0.05) in the OAGV group. Conclusions Ologen-augmentation increased the success and survival rates of AGVs in childhood glaucomas. Further, Ologen mitigated the hypertensive phase and decreased medication dependency. Longer follow-up with a greater number of eyes is required to fully evaluate the effectiveness of OAGV.

Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma

2018 ◽  
Vol 29 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Mohammad Pakravan ◽  
Hamed Esfandiari ◽  
Shahin Yazdani ◽  
Azadeh Doozandeh ◽  
Zahra Dastborhan ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Congenital Glaucoma ◽  
Ahmed Glaucoma Valve ◽  
Aphakic Glaucoma ◽  
Group 2 ◽  
Valve Implantation ◽  
Ahmed Glaucoma Valve Implantation ◽  
Group 1

Purpose: To evaluate the outcomes of Ahmed glaucoma valve implantation in refractory primary congenital glaucoma as well as primary procedure in aphakic glaucoma. Method: In this retrospective study, medical records of patients who underwent Ahmed glaucoma valve implantation for refractory glaucoma and aphakic glaucoma were reviewed. Primary outcome measures were the surgical success defined as intraocular pressure ≤21 mm Hg and decreased ≥20% and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity, and intraocular pressure. Results: A total of 62 eyes of refractory primary congenital glaucoma patients (group 1) and 33 eyes of aphakic glaucoma patients (group 2) were included in our study. Mean follow-up was 51 ± 33 months in group 1 and 49 ± 41 months in group 2 (p = 0.82). The cumulative probability of success was 90% in both groups at the first year; however, the success rate was 52.5% in group 1 and 71.5% in group 2 at 5 years’ follow-up visit. In group 1, the mean intraocular pressure ± standard deviation was 33.1 ± 8.6 mm Hg at the baseline and decreased to 17.1 ± 5.3 mm Hg at 1 year and 18.5 ± 6.4 at 3 years postoperatively (all p’s < 0.001). Corresponding values for group 2 were 28.9 ± 6.1, 15.2 ± 4.6, and 16.0 ± 5.9 mm Hg, respectively (all p’s < 0.001). The baseline number of glaucoma medications was 3 ± 0.7 that decreased to 2 ± 0.8 at final follow-up (p = 0.02). Conclusion: Ahmed glaucoma valve implantation has a moderate success rate in the management of refractory primary congenital glaucoma with an increased chance of tube-related complications. The surgical success rate is higher in case of primary Ahmed glaucoma valve implant for aphakic glaucoma with acceptable safety profile.

scholarly journals Ahmed valve in refractory glaucoma. Behavior of intraocular pressure at 24 months

2019 ◽  
Vol 92 (2) ◽  
Author(s):  
Rodolfo Monti ◽  
Evangelina Espósito ◽  
María E. Forniés-Paz ◽  
Nicolás Crim ◽  
Juan Dalmagro ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Refractory Glaucoma ◽  
Ahmed Valve

scholarly journals Outcome of Ahmed Glaucoma Valve in Refractory Glaucoma – Our Population Analysis

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Momina Faisal ◽  
Saadia Farooq ◽  
Hajra Farooq
Keyword(s):  
Population Analysis ◽  
Tertiary Care ◽  
Case Series ◽  
Cyst Formation ◽  
Safe Procedure ◽  
Care Hospital ◽  
Ahmed Glaucoma Valve ◽  
Refractory Glaucoma ◽  
Retrospective Case ◽  
Retrospective Case Series

Purpose:  To find out the outcomes of Ahmed Glaucoma Valve (AGV) implantation in a tertiary care hospital. Study Design:  Retrospective case series. Place and Duration of Study:  Shifa International Hospital Islamabad from January 2018 to July 2020. Methods:  This retrospective case series of 19 eyes of 17 patients with refractory glaucoma included patients who underwent AGV implantation with a follow-up period of 6 months to 01 year. AGV was done as a primary procedure in 3 patients and secondary procedure in 17 patients after a previously failed trabeculectomy. All patients underwent complete eye examination, before surgery and then at 1 month, 2months, 6 months and 1 year. Goldman tonometer was used to check IOP. Complications, interventions and the number of anti-glaucoma medications (in post-operative period) needed to achieve the target pressure were noted. Success was defined as an IOP of less than 18 mm Hg, with or without a single anti-glaucoma medication. Results:  Complete success was achieved in 57.9% and conditional success in 42.2%. The most common complication was encapsulated cyst formation in 31.6% and post-operative interventions were bleb deroofing in 10.5%, tube readjustment and tube wash in 10.5% and YAG vitreolysis in 5.3%. Conclusion:  AGV is an effective and relatively safe procedure in refractory glaucoma irrespective of initial diagnosis and age of the patient. Encapsulated bleb was the commonest complication. Key Words:  Ahmad Glaucoma valve, Glaucoma, Intra Ocular Pressure.

Micropulse transscleral cyclophotocoagulation using a standard protocol in patients with refractory glaucoma naive of cyclodestruction

2019 ◽  
pp. 112067211987758 ◽  
Author(s):  
Soufiane Souissi ◽  
Christophe Baudouin ◽  
Antoine Labbé ◽  
Pascale Hamard
Keyword(s):  
Intraocular Pressure ◽  
Diode Laser ◽  
Glaucoma Surgery ◽  
Refractory Glaucoma ◽  
Corrected Visual Acuity ◽  
Pressure Lowering ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean ◽  
Diode Laser Cyclophotocoagulation

Purpose: To assess the efficacy and safety of a standardized micropulse transscleral diode laser cyclophotocoagulation procedure in refractory glaucoma. Methods: Retrospective, interventional study in a series of 37 consecutive patients with refractory glaucoma, cyclodestructive procedure-naive, who underwent micropulse transscleral diode laser cyclophotocoagulation from December 2016 to October 2017. A successful laser treatment was defined as (1) intraocular pressure between 6 and 18 mm Hg; (2) 20% of baseline intraocular pressure reduction; (3) no additional glaucoma medications; (4) no decrease in vision due to complications or change in intraocular pressure; and (5) no need for additional glaucoma surgery except micropulse transscleral diode laser cyclophotocoagulation retreatment. Results: Mean age was 60.2 years. Mean follow-up was 9.7 ± 3.9 months. The mean preoperative intraocular pressure (28.7 mm Hg) significantly decreased to 21.0 mm Hg at 1 month, 18.5 mm Hg at 3 months, 18.4 mm Hg at 6 months, and 18.5 mm Hg at 12 months ( p < 0.01 at all time points). The mean number of preoperative glaucoma medications (4.7) decreased to 4.0 at 1 month ( p = 0.14), 4.5 at 3 months ( p < 0.05), 3.9 at 6 months ( p < 0.05), and 3.6 at 12 months ( p < 0.05). At 1 year, the success rate was 35% with a mean intraocular pressure lowering of 36%. One patient had hypotony and a loss of best-corrected visual acuity. Mild transient postoperative inflammation was observed in 8% of the cases. Conclusion: Using a standardized procedure, micropulse transscleral diode laser cyclophotocoagulation allows a mild intraocular pressure decrease with a low rate of complications and thus achieves a relatively good profit risk benefit, mostly for moderately hypertensive refractory glaucoma.

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