scholarly journals The results of the implantation of the Ahmed valve drainage devices for the treatment of refractory glaucoma in the children

2016 ◽  
Vol 11 (4) ◽  
pp. 174-178
Author(s):  
Valentina F. Ivanova
Keyword(s):  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Congenital Glaucoma ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Refractory Glaucoma ◽  
Hand Motion ◽  
Ahmed Valve ◽  
The Face ◽  
Valve Implantation

Purpose. To study and evaluate the safety and the effectiveness of Ahmed valve implantation for the treatment of refractory glaucoma in the children. Materials and methods. The study included 17 patients (18 eyes) at the age varying from 7 months to 15 years who had undergone the implantation of the Ahmed valve drainage devices for the treatment of uncompensated glaucoma. The FP7 and FP8 valve models were implanted into 7 eyes and 11 eyes respectively. Primary implantation was performed in 6 patients (6 eyes) and secondary implantation in 11 ones (12 eyes). The follow-up period after the implantation ranged from 1 months to 6 years (mean 17,7 ± 5,7 months). Results. All the patients presented with the severe forms of refractory glaucoma including multiply corrected (by surgical intervention) uncompensated congenital glaucoma, concomitant glaucoma, and secondary glaucoma. Terminal glaucoma occurred in 7 eyes and far-advanced glaucoma in 9 eyes. The mean intraocular pressure (IOP) before surgery was 32,2 ± 8,3 mm Hg, mean postoperative IOP 17,5 ± 6,3 mm Hg. No intraoperative complications were documented. The postoperative complications in the form of cilio-choroidal detachment developed in 4 children, posterior retraction of the drainage tube, vertical strabismus, and eyeball subatrophy in 1 patient each. The perfectly successful outcome of the operation and compensation of IOP without the additional prescription of the anti-hypertensive drugs were achieved in 12 (70,5%) patients (13 eyes); however, the number of such eyes decreased to 8 or 44,5% within 6 and more months after surgery even though IOP remained compensated due to anti-hypertensive medication. Five (29,5%) children had compensated IOP immediately after surgery as a result of the intake of anti-hypertensive preparations; in two of them IOP was normalized within 6-12 months without prescription of the anti-hypertensive medication. Visual acuity in the end of the observation period remained unaltered in 12 eyes and was improved to 0,02 in 6 eyes upon hand motion near the face due to the reduction of corneal oedema. Conclusion. Despite the small number of the patients included in the present study, the results obtained give evidence that the application of the Ahmed valve drainage devices provides an efficient tool for the reduction of IOP in the children presenting with refractory glaucoma. However, this treatment modality is associated with the risk of serious complications that can be prevented by the choice of the correct indications, the adequate surgical techniques, and the treatment modalities ensuring careful postoperative care.

scholarly journals Safety and Efficacy of Second Ahmed Valve Implant in Refractory Glaucoma

2020 ◽  
Vol 9 (7) ◽  
pp. 2039
Author(s):  
Chiara Posarelli ◽  
Mario Damiano Toro ◽  
Robert Rejdak ◽  
Tomasz Żarnowski ◽  
Dorota Pożarowska ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Demographic Data ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Refractory Glaucoma ◽  
Safety And Efficacy ◽  
Surgical Success ◽  
Ahmed Valve ◽  
Valve Implantation ◽  
Type 3

Background: Refractory glaucoma still represents a challenge for ophthalmologists to manage intraocular pressure. The present study aimed to evaluate long term efficacy and safety of a second Ahmed valve implantation after the failure of a first implant in patients with refractory glaucoma and elevated intraocular pressure (IOP). Methods: Retrospective, multicenter non-comparative case series. Twenty-eight patients were retrospectively recruited between January 2011 and December 2017. Demographic data, glaucoma type, visual acuity, intraocular pressure, medical therapy, and complications were registered. Three criteria of success were established: Type 1 surgical success: IOP ≤ 15 mmHg and a reduction of IOP ≥ 40% from baseline; Type 2 surgical success: IOP ≤ 18 mmHg and a reduction of IOP ≥ 30% from baseline; and Type 3 surgical success: IOP ≤ 21 mmHg and a reduction of IOP ≥ 20% from baseline. Surgical failure has been established as IOP less than 5 mmHg or over 21 mmHg and less than a 20% reduction of IOP from baseline despite medications in two consecutive visits, light perception loss referable to glaucoma, and the necessity for further glaucoma surgery. Failure was observed in six (21%) patients. (3) Results: Mean IOP and mean glaucoma medication number significantly reduced from baseline after the second implantation, and the surgical success rate at 72 months ranged from 10% to 78% based on the different criteria of success. Failure was observed in six (21%) patients. Conclusions: This study confirmed the safety and efficacy of a second Ahmed valve implantation in patients with refractory glaucoma and elevated IOP at baseline.

scholarly journals Long-term clinical outcomes of Ahmed valve implantation in patients with refractory glaucoma

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0187533 ◽  
Author(s):  
Chang Kyu Lee ◽  
Kyoung Tak Ma ◽  
Young Jae Hong ◽  
Chan Yun Kim
Keyword(s):  
Clinical Outcomes ◽  
Refractory Glaucoma ◽  
Ahmed Valve ◽  
Valve Implantation

Combined Phacoemulsification and Ahmed Valve Glaucoma Drainage Implant: A Retrospective Case Series

2008 ◽  
Vol 18 (2) ◽  
pp. 191-198 ◽  
Author(s):  
N. Nassiri ◽  
N. Nassiri ◽  
S. Sadeghi Yarandi ◽  
B. Mohammadi ◽  
L. Rahmani
Keyword(s):  
Visual Acuity ◽  
Intraoperative Complications ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Success Rates ◽  
Retrospective Case ◽  
Antiglaucoma Medication ◽  
Ahmed Valve ◽  
The Mean ◽  
Valve Implantation

Purpose To report on the efficacy and safety of combined phacoemulsification and an Ahmed valve glaucoma drainage implant with respect to visual acuity improvement, intraocular pressure (IOP) control, and requirement for antiglaucoma medication. Methods A retrospective chart review was conducted of 41 eyes (31 patients) with coexisting visually significant cataracts and uncontrolled glaucoma who had combined phacoemulsification and Ahmed valve implantation. The outcome measures were: visual acuity, IOP, antiglaucoma medication requirements, and intra- and post-operative complications. Success was categorized as absolute (IOPp<21 mmHg without the need for antiglaucoma medication) and relative (IOPp<21 mmHg with one or more antiglaucoma medications). Failure was considered to be an IOPp<6 mmHg or IOP>21 mmHg on maximally tolerated medications or any devastating complication. Results The mean patient age was 67.3±5.9 years old. The mean visual acuity improved from 0.73±0.5 to 0.16±0.16 (p=0.000). The mean IOP decreased from 28.2±3.1 to 16.8±2.1 (p=0.000, 40.4%), while the number of antiglaucoma medication decreased from 2.6±0.66 to 1.2±1.4 (p=0.000). The absolute and relative success rates were 56.1% and 31.7%, respectively; 5 eyes (12.2%) were considered failures. There were no intraoperative complications; postoperative complications occurred in 8 eyes (19.5%). A hypertensive phase was detected in 12 (29.3%) eyes. Conclusions Combined phacoemulsification and Ahmed valve glaucoma drainage implantation is a safe and effective alternative to phacotrabeculectomy in patients with coexisting cataract and refractory glaucoma.

Current Strategies in the Management of Spinal Metastatic Disease

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Bartanusz ◽  
Porchet
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Cord Compression ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Spinal Stabilization ◽  
Management Algorithm ◽  
Specific Manner ◽  
Extensive Surgery ◽  
Selection Of

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.

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