Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma

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.

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Risk factors and outcomes of management of delayed suprachoroidal haemorrhage following Ahmed glaucoma valve implantation in children

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313804 ◽

2019 ◽

Vol 104 (1) ◽

pp. 115-120 ◽

Cited By ~ 1

Author(s):

Shantha Balekudaru ◽

Tamonash Basu ◽

Parveen Sen ◽

Pramod Bhende ◽

Vijaya Lingam ◽

...

Keyword(s):

Risk Factors ◽

Univariate Analysis ◽

Congenital Glaucoma ◽

Ahmed Glaucoma Valve ◽

Retrospective Case ◽

Incidence Risk ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation ◽

Control Study

AimsTo assess the incidence, risk factors and outcomes of management of delayed suprachoroidal haemorrhage (DSCH) in children who had undergone Ahmed glaucoma valve implantation.MethodsA retrospective case-control study of eyes which developed DSCH in children <18 years of age who underwent surgery between January 2009 and December 2017 with a follow-up of at least 2 months was performed. Nine cases were compared with 27 age, gender and surgeon matched controls who had undergone surgery during this period.ResultsThe incidence of DSCH was 4.7% (95% CL 1.5% to 7.7%, 9 eyes of 191 children). There were no significant differences between cases and controls in baseline details except for the number of intraocular pressure (IOP) lowering medications (p=0.01) and follow-up period (p=0.001). Risk factors identified on univariate analysis (p≤0.1) were axial length (p=0.02), diagnosis of primary congenital glaucoma (p=0.05), postoperative hypotony (p=0.07) and aphakia (p=0.1). None of them were found to be significant on multivariate analysis. Five eyes, three with retinal apposition and two with retinal detachment, underwent surgical drainage. There were no significant differences in the outcomes of eyes which underwent drainage compared with those which did not. Failures, defined as IOP>18 mm Hg despite use of medications, loss of light perception, phthisis or removal of the implant were more frequent in cases (three eyes, 33.3%) compared with controls (four eyes, 14.8%) (p=0.002).ConclusionsNone of the risk factors analysed in our series proved to be significant. Failures were more common in eyes with choroidal haemorrhage, despite surgical intervention.

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Ahmed Glaucoma Valve Implantation with the Tube Placement in the Ciliary Sulcus: Short Term Results

10.21203/rs.3.rs-264845/v1 ◽

2021 ◽

Author(s):

Gul Arikan ◽

Betul Akbulut ◽

Canan Asli Utine ◽

Ziya Ayhan ◽

Mahmut Kaya ◽

...

Keyword(s):

Intraocular Pressure ◽

Pressure Level ◽

Tube Placement ◽

Ahmed Glaucoma Valve ◽

Glaucoma Diagnosis ◽

Aphakic Eyes ◽

The Mean ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation

Abstract Purpose: To evaluate the clinical outcomes of pseudophakic/aphakic eyes with uncontrolled glaucoma that underwent Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus.Methods: Medical records of the patients who underwent Ahmed glaucoma valve implantation through the ciliary sulcus, between December 2017 and June 2019, were reviewed retrospectively. Patients’ age, gender, glaucoma diagnosis, visual acuity, intraocular pressure levels and complications were recorded. Results: Forty-seven eyes of 43 patients with glaucoma were enrolled. The mean age was 54.5 ± 19.9 years (range, 7 - 88 years) at the time of surgery and the mean postoperative follow-up period was 7.9 ± 3.4 months (range, 3 -16 months). The mean preoperative intraocular pressure level was 35.2 ±6.8 mmHg (range, 25-55 mmHg) and it was found as 15.6 ± 5.4 mmHg (range, 9-33 mmHg) at last follow-up visit. Decrease in intraocular pressure level was statistically significant (P < 0.001). At last follow-up visit success was achieved in 41 eyes (87.2 %). Hyphema was the most common postoperative complication and developed in 11 eyes (23.4%) and resolved spontaneously in all of them within one month.Conclusion: In pseudophakic or aphakic eyes with uncontrolled glaucoma, placement of Ahmed glaucoma valve tube in the ciliary sulcus is a safe and effective procedure. Ciliary sulcus can be considered as a potential space during tube shunt surgery in eyes with high risk of tube-corneal touch or corneal decompensation.

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

International Journal of Ophthalmology ◽

10.18240/ijo.2021.10.13 ◽

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.

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Changes in Corneal Endothelial Cells after Ahmed Glaucoma Valve Implantation: 2-Year Follow-up

Yearbook of Ophthalmology ◽

10.1016/s0084-392x(10)79333-3 ◽

2010 ◽

Vol 2010 ◽

pp. 95-97

Author(s):

J.S. Myers

Keyword(s):

Endothelial Cells ◽

Ahmed Glaucoma Valve ◽

Corneal Endothelial Cells ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation

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Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up

Acta Ophthalmologica ◽

10.1111/aos.12493 ◽

2014 ◽

Vol 93 (1) ◽

pp. e1-e6 ◽

Cited By ~ 13

Author(s):

Enyr S. Arcieri ◽

Jayter S. Paula ◽

Rodrigo Jorge ◽

Kleyton A. Barella ◽

Rafael S. Arcieri ◽

...

Keyword(s):

Intravitreal Bevacizumab ◽

Neovascular Glaucoma ◽

Efficacy And Safety ◽

Ahmed Glaucoma Valve ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation

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The effectiveness of descemethogoniopuncture depending on the timing of its implementation after microinvasive non-penetrating deep sclerectomy in patients with glaucoma

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-1-79-82 ◽

2021 ◽

pp. 79-82

Author(s):

E.L. Sorokin ◽

◽

N.V. Postupaeva ◽

◽

Keyword(s):

Intraocular Pressure ◽

Antihypertensive Effect ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Hypotensive Effect ◽

Ultrasound Biomicroscopy ◽

Deep Sclerectomy ◽

Group 2 ◽

Group 1

Purpose. Evaluation of the efficacy of descemethogoniopuncture (DGP) at various times after microinvasive non-penetrating deep sclerectomy (MNPDS) in patients with glaucoma. Material and methods. The analysis of the results of DGP in 64 eyes of patients with primary open-angle glaucoma after previously performed MNPDS. According to the timing of DGP after MNPDS, the patients were divided into 3 groups. In the 1st group BPH was performed after 1–2 months (22 eyes), the 2nd group – after 3–4 months (21 eyes), the 3rd group after 5–6 months (21 eyes). The follow-up period was 1 year. Results. The level of intraocular pressure before DGP averaged 15.1±0.6 mm Hg in group 1, 17.5±0.9 mm Hg in group 2, and group – 18.6±0.7 mm Hg. After DGP, 13.1±0.4 mm Hg, 14.6±0.7 mm Hg, 16.1±0.5 mm Hg respectively. According to ultrasound biomicroscopy, the highest and extended intrascleral cavities and tunnels, as well as a thin loose trabeculodescemet membrane (TDM), were observed in the eyes of the 1st group. With an increase in the time after MNPDS, there was a compaction of TDM, a decrease in the height and length of the intrascleral cavity and tunnels. 12 months after DGP, the most pronounced antihypertensive effect without antihypertensive therapy occurred in group 1 – 55% of cases compared with groups 2 and 3 (33% and 14% respectively). Conclusion. The greatest efficiency was shown by performing DGP within 1–2 months after MNPDS, which is associated with the minimum development of proliferative processes in the intrascleral outflow tract in the early stages after this operation. Key words: descemethogoniopuncture, microinvasive non-penetrating deep sclerectomy, intraocular pressure, hypotensive effect, glaucoma.

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Results of Ahmed glaucoma valve implantation in primary congenital glaucoma

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/j.jaapos.2014.08.008 ◽

2014 ◽

Vol 18 (6) ◽

pp. 590-595 ◽

Cited By ~ 11

Author(s):

M. Reza Razeghinejad ◽

Saeed Kaffashan ◽

Mohammad H. Nowroozzadeh

Keyword(s):

Congenital Glaucoma ◽

Ahmed Glaucoma Valve ◽

Primary Congenital Glaucoma ◽

Valve Implantation ◽

Ahmed Glaucoma Valve Implantation

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XEN Glaucoma Implant for the Management of Glaucoma in Naïve Patients versus Patients with Previous Glaucoma Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10194417 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4417

Author(s):

Katarzyna Lewczuk ◽

Joanna Konopińska ◽

Joanna Jabłońska ◽

Jacek Rudowicz ◽

Patrycja Laszewicz ◽

...

Keyword(s):

Success Rate ◽

Glaucoma Surgery ◽

Minimal Invasiveness ◽

Refractive Outcomes ◽

Long Term Follow Up ◽

Initial Procedure ◽

The Mean ◽

Group 2 ◽

Group 1

This retrospective study analyzed the surgical and refractive outcomes of a XEN Gel Implant (Allergan, Abbvie Company, Irvine, CA, USA) in naïve patients versus those with previous glaucoma surgery. We evaluated the efficacy of XEN implantation in 86 glaucoma patients during a long-term follow-up period. Patients were divided into two groups: naïve patients (Group 1) and patients with previous glaucoma surgery (Group 2). Eyes that received a XEN Gel Stent placement from December 2014 to October 2019 were included. Intraocular pressure (IOP) change, corrected distance visual acuity (CDVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. In Group 1, the mean IOP before surgery was decreased significantly from 25.00 ± 7.52 mmHg to 16.83 ± 5.12 mmHg by the end of the study. In Group 2, the mean IOP decreased significantly from 25.35 ± 7.81 mmHg to 17.54 ± 5.34 mmHg. The mean IOP decrease from baseline was 29% in Group 1 and 27% in Group 2 (p = 0.567). There were no significant differences between the groups in the IOP baseline level, the final level, or the change between preoperative and final levels. The qualified success rate for Group 2 was 68.7% versus 76.5% for Group 1 for the initial procedure and 15.4% vs. 20.2%, respectively, for complete success rate (p > 0.05). However, at the end of the follow-up, more patients achieved an IOP < 18 mmHg in Group 1 than in Group 2. Despite the need for more anti-glaucoma medications, repeat XEN Gel implantation appears to show promising results in patients with previously failed anti-glaucoma procedures, owing to its minimal invasiveness.

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