Clinical Outcomes of Ahmed Glaucoma Valve in Posterior Segment Versus Anterior Chamber

Purpose: To describe the application of a modified Ahmed glaucoma valve (AGV) surgical implantation technique in vitrectomized eyes, in order to minimize the risk of early postoperative hypotony, which leads to hemorrhagic complications. Materials and methods: Data of patients implanted with AGV using the surgical technique described were retrospectively reviewed. Inclusion criterion: glaucomatous eyes with previous history of pars plana vitrectomy. Intraocular pressure (IOP) measurement and ophthalmic examination were performed preoperatively and postoperatively weekly for 1 month for the detection of early hypotony, choroidal effusion/detachment, intraocular hemorrhage. The surgical technique consisted in creating a 5 mm long scleral tunnel with a 23 G needle reaching the anterior chamber at the iridocorneal angle, in which the Ahmed glaucoma valve tube was inserted. Results: Ten eyes of 10 patients were included. Median preoperative IOP was 30.5 mmHg [interquartile range (IQR) 28.3–33.0]; median postoperative IOP was 12.0 mmHg (IQR 9.3–13.0) at 1 week, and 12.5 mmHg (IQR 11.0–15.0) at 1 month. In no cases postoperative IOP was <8 mmHg. On the first postoperative day, five (50%) eyes showed few blood clots in the anterior chamber. On the second-week appointment, moderate choroidal effusion was observed in two eyes (20%). No hemorrhagic complications were observed. Conclusions: The creation of a long intrascleral tunnel with a 23 G needle for AGV implantation in vitrectomized eyes could be effective in decreasing leakage through the space between the valve tube and the sclerocorneal tissue. This technique is safe, easy to perform, feasible and fast. Due to its advantages and good postoperative results, it could also be adopted in non-vitrectomized eyes.

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Long-term Clinical Outcomes of Pars Plana Versus Anterior Chamber Placement of Glaucoma Implant Tubes

Journal of Glaucoma ◽

10.1097/ijg.0000000000000931 ◽

2018 ◽

Vol 27 (5) ◽

pp. 440-444 ◽

Cited By ~ 2

Author(s):

Vivian L. Qin ◽

Mona Kaleem ◽

Felipe F. Conti ◽

Edward J. Rockwood ◽

Annapurna Singh ◽

...

Keyword(s):

Anterior Chamber ◽

Clinical Outcomes ◽

Pars Plana

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Clinical Outcomes of Ahmed Glaucoma Valve Implantation Using Tube Ligation and Removable External Stents

Korean Journal of Ophthalmology ◽

10.3341/kjo.2009.23.2.86 ◽

2009 ◽

Vol 23 (2) ◽

pp. 86 ◽

Cited By ~ 13

Author(s):

Jong Joo Lee ◽

Ki Ho Park ◽

Dong Myung Kim ◽

Tae Woo Kim

Keyword(s):

Clinical Outcomes ◽

Ahmed Glaucoma Valve ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation ◽

Tube Ligation

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Clinical Evaluation of the NS Endo-Inserter, a Novel Donor Inserter for Descemet’s Stripping Automated Endothelial Keratoplasty

Case Reports in Ophthalmology ◽

10.1159/000503441 ◽

2019 ◽

Vol 10 (3) ◽

pp. 357-364

Author(s):

Akira Kobayashi ◽

Hideaki Yokogawa ◽

Natsuko Mori ◽

Tsubasa Nishino ◽

Kazuhisa Sugiyama

Keyword(s):

Anterior Chamber ◽

Clinical Outcomes ◽

Intraoperative Complications ◽

Case Series ◽

Argon Laser ◽

Bullous Keratopathy ◽

Endothelial Keratoplasty ◽

Donor Tissue ◽

Laser Iridotomy ◽

Cell Densities

Purpose: This study investigated the clinical outcomes achieved with a newly developed donor inserter (NS Endo-Inserter [NSI], HOYA Co., Ltd., Tokyo, Japan) for Descemet’s stripping automated endothelial keratoplasty (DSAEK) in Japanese eyes with bullous keratopathy secondary to argon laser iridotomy (BK-ALI). The NSI device utilizes pressure flow to push the DSAEK donor tissue into the anterior chamber. Methods: Six eyes of 6 patients (1 male, 5 females; mean age, 78.5 years) with BK-ALI were enrolled. Donor tissue was pushed into the anterior chamber using the NSI. Intraoperative complications, graft dislocation, and iatrogenic primary graft failure were recorded for all eyes. Six-month postoperative central donor endothelial cell densities (ECD) were measured prospectively and compared with preoperative values, along with 6-month best corrected visual acuity (BCVA). Results: In all cases, donor loading onto the NSI spatula and donor insertion into the anterior chamber using the NSI was smooth and successful; no intraoperative complications were noted. There were no cases of graft dislocation or IPGF. Postoperative ECD was 2,187.2 cells/mm2 (mean loss, 14.8%) and mean BCVA increased from 0.27 decimal to 0.8 at 6 months. Conclusion: In this small preliminary case series, clinical outcomes for patients with BK-ALI undergoing DSAEK using the NSI were comparable or better than those achieved with conventional DSAEK insertion techniques.

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Risk Factors of Shallow Anterior Chamber Other Than Hypotony After Ahmed Glaucoma Valve Implant

Journal of Glaucoma ◽

10.1097/ijg.0b013e31816b2fe7 ◽

2009 ◽

Vol 18 (1) ◽

pp. 44-48 ◽

Cited By ~ 11

Author(s):

Hae Young Park ◽

Na Young Lee ◽

Chan Kee Park

Keyword(s):

Risk Factors ◽

Anterior Chamber ◽

Ahmed Glaucoma Valve ◽

Shallow Anterior Chamber

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SHAPU: Forty years on Mystery Persists

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v9i1.17527 ◽

2017 ◽

Vol 9 (1) ◽

pp. 13-16 ◽

Cited By ~ 4

Author(s):

Madan P Upadhyay ◽

Bharat R Shrestha

Keyword(s):

Anterior Chamber ◽

Aqueous Humor ◽

Posterior Segment ◽

The Other ◽

Eye Disease ◽

Rapid Loss ◽

Inflammatory Eye Disease ◽

Fungal Organisms ◽

Shallow Anterior Chamber ◽

White Pupil

In 1975, our team encountered several cases of severe inflammatory eye disease presenting as a white pupil in a red eye with rapid loss of vision. The eyes became soft within a few days with shallow anterior chamber which we called “Malignant Hypotension” in view of the latter’s sinister significance. Unilaterally, little or no pain, predominantly affecting children and difficulty in dilating the pupil and keeping it dilated were some of the other important features. Posterior segment was not visible due to massive exudation in vitreous. Microbiological investigations of aqueous humor did not retrieve any bacterial or fungal organisms. All eyes became pthisical in few weeks despite treatment with topical and subconjunctival antibiotics and steroids. Similar cases appeared again after two years in 1977 with identical presentation and outcome. Both out breaks began during September and lasted until about January- the next year.

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