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.

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

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.

Outcomes of bleb revision with ologen following filtering glaucoma surgery

2021 ◽  
pp. 112067212110535
Author(s):  
Helen L. Kornmann ◽  
Ronald L. Fellman ◽  
Oluwatosin U. Smith ◽  
David G. Godfrey ◽  
Michelle R. Butler ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Retrospective Chart Review ◽  
Collagen Matrix ◽  
Glaucoma Surgery ◽  
Long Term Outcomes ◽  
Additional Surgery ◽  
Bleb Leak ◽  
Bleb Failure

Purpose This study reports long-term outcomes of bleb revision with ologen™ Collagen Matrix (Aeon Astron Europe BV, the Netherlands) for the surgical management of various bleb-related issues including persistent bleb leaks with or without associated hypotony, bleb dysesthesia, overhanging blebs, or hypotony after filtering glaucoma surgery. Materials and methods A retrospective chart review was performed for patients who underwent ologen bleb revision from 2012 to 2019 at Glaucoma Associates of Texas. Results The study included 23 eyes of 22 patients undergoing bleb revision with the ologen implant. Mean age was 74.0 ± 11.3 years, 16 (69.6%) were female, and 13 (56.5%) were White. Indications for bleb revision included bleb leak (78.3%), dysesthesia (13.0%), and hypotony from an overfiltering bleb (8.7%). Mean preoperative intraocular pressure was 6.8 ± 4.1 mmHg and the number of medications was 0.3 ± 0.9. Median follow-up was 24 months (range: 12–84 months); all patients had at least 12 months of follow-up. At 1 year, mean intraocular pressure was 10.9 ± 4.6 mmHg on 0.2 ± 0.5 medications, and at last follow-up, mean intraocular pressure was 10.4 ± 3.6 mmHg on 0.3 ± 0.7 medications. Bleb morphology remained low, diffuse, and posterior. One patient developed kissing choroidal effusions requiring surgical drainage with subsequent stabilization of intraocular pressure and bleb function, and three patients required additional surgery due to persistent leaks or bleb failure; there were no other vision-threatening complications. Conclusions Use of the ologen implant during surgical bleb revision is a useful surgical technique that confers long-term improvements in bleb morphology and stability of function.

scholarly journals Biodegradable 3D-Porous Collagen Matrix (Ologen) Compared with Mitomycin C for Treatment of Primary Open-Angle Glaucoma: Results at 5 Years

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Fei Yuan ◽  
Lei Li ◽  
Xiuping Chen ◽  
Xiang Yan ◽  
Liyang Wang
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Collagen Matrix ◽  
Open Angle ◽  
Significant Difference ◽  
The Difference ◽  
Rate Of Success

Purpose. To evaluate the effectiveness and safety of the Ologen as an aid for trabeculectomy performed for primary open-angle glaucoma compared with mitomycin C.Methods. In this prospective, randomized, parallel assignment, comparative study, 31 eyes of 21 primary open-angle glaucoma patients were allocated for trabeculectomy with the Ologen implant; another 32 eyes of 23 patients were treated with trabeculectomy augmented with mitomycin C. The patients were followed up for 5 years and evaluated for intraocular pressure, rate of success, status of the bleb, and adverse events.Result. The mean postoperative intraocular pressure was statistically different at 3 m, 6 m, 1 y, 3 y, and 5 y follow-up. The rates of both complete successP=0.017and overall successP=0.031in the Ologen group were significantly higher than those in the mitomycin C group. The difference of the bleb extent and vascularity was statistically significant in both groups. There was no significant difference in postoperative complication.Conclusions. Ologen provides higher rates of surgical success compared with mitomycin C for patients with primary open-angle glaucoma undergoing trabeculectomy. It may be a new, safe, simple, and effective therapeutic approach for treating primary open-angle glaucoma.

Corticosteroids Versus NSAIDs on Intraocular Pressure and the Hypertensive Phase After Ahmed Glaucoma Valve Surgery

2011 ◽  
Vol 20 (7) ◽  
pp. 439-444 ◽  
Author(s):  
Darana Yuen ◽  
Yvonne Buys ◽  
Ya-Ping Jin ◽  
Tariq Alasbali ◽  
Michael Smith ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Valve Surgery ◽  
Ahmed Glaucoma Valve ◽  
Hypertensive Phase

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 Impact of Same-Session Trabectome Surgery on Ahmed Glaucoma Valve Outcomes

2018 ◽  
Author(s):  
Hamed Esfandiari ◽  
Tarek Shazly ◽  
Priyal Shah ◽  
Kiana Hassanpour ◽  
Pooya Torkian ◽  
...  
Keyword(s):  
Survival Rates ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Cumulative Probability ◽  
Ahmed Glaucoma Valve ◽  
Trabectome Surgery ◽  
Hypertensive Phase ◽  
One Year

Purpose: To evaluate the efficacy and survival rates of same session ab interno trabeculectomy with the trabectome and Ahmed glaucoma valve implant (AT) in comparison to the Ahmed glaucoma valve alone (A). Method: A total of 107 eyes undergoing primary glaucoma surgery were enrolled in this retrospective comparative case series, including 48 eyes which underwent AT and 59 eyes which received A alone. Participants were identified using the procedural terminology codes, and their medical records were reviewed. The primary outcome measure was surgical success, defined as intraocular pressure (IOP) &gt; 5 mmHg, &le; 21 mmHg, and IOP reduction &ge; 20% from baseline at two consecutive visits after three months, no reoperation for glaucoma. Secondary outcome measures were IOP, the number of glaucoma medications, incidence of a hypertensive phase, and best corrected visual acuity (BCVA). Results: The cumulative probability of success at one year was 70% in AT, and 65% in A (p=0.85). IOP decreased significantly from 26.6 &plusmn; 10.1 mmHg at baseline to 14.7 &plusmn; 3.3 mmHg at the final follow-up in AT (p= 0.001). The corresponding numbers for A were 28.8 &plusmn; 10.2 and 16.7 &plusmn; 4.9, respectively (p= 0.001). The final IOP was significantly lower in AT (p= 0.022). The number of medications at baseline was comparable in both groups (2.6 &plusmn; 1.2 in AT and 2.5 &plusmn; 1.3 in A, p=0.851). Corresponding number at 1 year visit was 1.2&plusmn;2 in AT and 2.8&plusmn;1.8 in A (p=0.001). The incidence of a hypertensive phase was 18.7% in AT and 35.5% in A (p=0.05). HP resolved in only 30% of eyes. The criteria for HP resolution were fulfilled in 9 eyes (30%). There was no difference in the rate of resolution of the hypertensive phase between AT and A (33.3% and 28.5%, respectively, p=0.67). Conclusion: Ahmed glaucoma valve implant with same session trabectome surgery significantly decreased the rate of the hypertensive phase and postoperative IOP as well as the number of glaucoma medications.

scholarly journals Association between hyperpyrexia and poststroke outcomes in patients with recanalization after mechanical thrombectomy: a retrospective cohort study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Man Chen ◽  
Jinghuan Fang ◽  
Xintong Wu ◽  
Qin Liu ◽  
Ling Feng ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Independent Predictor ◽  
Survival Rates ◽  
Functional Independence ◽  
Continuous Variable ◽  
Stroke Recovery ◽  
Limited Data ◽  
Kaplan Meier ◽  
The Relationship

Abstract Background Limited data are available for evaluating the relationship between the prognosis and body temperature (BT) in patients treated with mechanical thrombectomy (MT), especially in those with successful recanalization. We aimed to explore the prognostic value of BT in predicting outcomes of stroke recovery at 3 months poststroke. Methods We retrospectively analyzed the relationship among BT levels as a continuous variable, with fever (BT ≥ 37.5℃) as a binary variable, and obtained several outcomes of interest. Subjects were stratified according to successful recanalization (thrombolysis in cerebral infarction scores of 2b-3) following MT. Functional independence was defined as a modified Rankin scale (mRS) score of 0–2. Results In total, 258 patients were included. The proportion of patients with functional independence was significantly lower among patients with BT ≥ 37.5℃ than among those with BT < 37.5 °C (45.3 % versus 23.0 %; P < 0.001). In the multivariate analysis, hyperpyrexia (especially BT ≥ 38 °C) was significantly associated with poor 3-month outcomes in patients treated with MT. Subgroup analysis was conducted by comparing the successful recanalization group with the non-recanalization group, showing that BT ≥ 37.5 °C was associated with a significantly lower proportion of functional independence in the recanalized patients. Besides, the Kaplan-Meier model showed that the fever group had significantly lower survival rates than the non-fever group during the 3-month follow-up. Conclusions In patients treated with MT, hyperpyrexia is an independent predictor of poststroke outcomes at 3 months, particularly in those with successful recanalization.

scholarly journals Ahmed Glaucoma Valve Implantation: Graft-Free Short Tunnel Small Flap versus Scleral Patch Graft After 1 Year Follow-Up: A Randomised Clinical Trial

2018 ◽  
Author(s):  
Mohammad Pakravan ◽  
Mohammadmehdi Hatami ◽  
Hamed Esfandiari ◽  
Shahin Yazdani ◽  
Azadeh Doozandeh ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intraocular Pressure ◽  
Success Rate ◽  
Randomised Clinical Trial ◽  
Cumulative Probability ◽  
Ahmed Glaucoma Valve ◽  
Patch Graft ◽  
One Year ◽  
Short Tunnel

Purpose: To compare the efficacy and safety of graft-free short tunnel small flap (STSF) technique with that of scleral patch graft (SPG) in Ahmed glaucoma valve (AGV) implantation. &nbsp;Design: Randomized clinical trial. &nbsp;Participants: Eighty-eyes of eighty patients with medically uncontrolled glaucoma including 41 in STSF and 39 eyes in SPG. Methods: Patients were enrolled and assigned randomly to STSF or SPG. &nbsp;Main Outcome Measures: tube exposure, Intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), surgical complications, and success rate ( defined as intraocular pressure (IOP) &gt;5 mmHg, &le;21 mmHg, and IOP reduction &ge;20% from baseline at two consecutive visits after three months, no reoperation for glaucoma). &nbsp;Results: only one case in SPG developed tube exposure at 1-year follow-up. The cumulative probability of success during the first year of follow-up was 70% in the STSF and 65% in SPG (P = 0.36). IOP decreased significantly from 29.6 &plusmn; 8.6 mmHg at baseline to 16.4 &plusmn; 3.6 mmHg at the final follow-up in STSF (p = 0.001). The corresponding numbers for SPG were 30.9 &plusmn; 11.2 and 15.8 &plusmn; 4.7, respectively (p = 0.001). The final IOP was comparable between both groups (p = 0.65). Mean &plusmn; standard deviation of the number of glaucoma medications was 1.8 &plusmn; 0.9 in STSF and 1.6 &plusmn; 0.9 in SPG at final follow-up (P = 0.32). Postoperative complications developed in 8 patients (19%) in STSF and 9 patients (23%) in SPG (P = 0.81). &nbsp;Conclusions: STSF and SPG techniques had comparable complication rate at one-year follow-up. Both techniques were comparable in terms of success rate, postoperative IOP, and glaucoma medications.

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