Retrospective analysis of patients with refractory glaucoma using Ahmed valve implantation

2020 ◽  
pp. 32-35
Author(s):  
O.V. Chayka ◽  
◽  
A.E. Babushkin ◽  
Keyword(s):  
Retrospective Analysis ◽  
Refractory Glaucoma ◽  
Ahmed Valve ◽  
Valve Implantation

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

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.

Ahmed valve implantation efficiency in children with refractory uveitic glaucoma

2020 ◽  
pp. 144-145
Author(s):  
M.A. Khrabrova ◽  
◽  
L.A. Katargina ◽  
E.V. Denisova ◽  
N.A. Ibaidbahaaeddin ◽  
...  
Keyword(s):  
Uveitic Glaucoma ◽  
Ahmed Valve ◽  
Valve Implantation

Актуальность. Постувеальная глаукома (ПУГ) представляет собой одну из самых тяжелых глауком детского возраста. Имплантации дренажей при ПУГ у детей посвящены лишь единичные работы, а полученные результаты неоднозначны, что требует дальнейшего изучения данного вопроса. Цель. Оценить эффективность имплантации клапана Ахмеда у детей с рефрактерной постувеальной глаукомой (ПУГ). Материал и методы. Имплантация клапана Ахмеда была проведена 10 детям в возрасте от 7 до 17 лет (10 глаз) с некомпенсированной на максимальном гипотензивном режиме открытоугольной или смешанной формой ПУГ. Ранее всем пациентам было выполнено в среднем 2,1±0,9 операций, направленных на нормализацию внутриглазного давления (ВГД). 6 глаз были артифакичными, 2 факичными, 2 афакичными. Имплантация клапана Ахмеда проводилась по общепринятой методике. ВГД на момент операции было в среднем 30,50±4,35 мм рт.ст. Компенсацией глаукомы считали ВГД≤24 мм рт.ст. и отсутствие симптомов прогрессирования глаукомного процесса. Срок наблюдения после операции составил от 3,9 до 23,6 месяцев (в среднем – 14,1±6,5). Результаты. Стойкий гипотензивный эффект вмешательства достигнут в 90% случаев, из них у 3 пациентов без гипотензивного режима, у 6 – на фоне препаратов. Среднее количество гипотензивных препаратов после операции составило 1,7±1,49 (значительно меньше по сравнению с периодом до операции, р=0,028). В конце периода наблюдения среднее значение ВГД составило 18,1±5,34 мм рт.ст. (р=0,008). Во время операции у 1 пациента после парацентеза отмечалось кровотечение из сосудов угла передней камеры, остановленное тампонадой стерильным воздухом. В остальных случаях вмешательство, ближайший и отдаленный послеоперационный период протекали без осложнений. Выводы. Имплантация клапана Ахмеда является эффективным и безопасным способом хирургического лечения рефрактерной ПУГ у детей и может быть рекомендована при неэффективности предшествующих антиглаукоматозных операций, в том числе пациентам с артифакией и афакией.

Postoperative complications after Ahmed valve implantation

2016 ◽  
Vol 12 (2) ◽  
pp. 103-107
Author(s):  
M.M. Bikbov ◽  
◽  
I.I. Husnitdinov ◽  
Keyword(s):  
Postoperative Complications ◽  
Ahmed Valve ◽  
Valve Implantation

scholarly journals Ahmed valve implantation results in children with uveitic glaucoma

2021 ◽  
Vol 14 (1) ◽  
pp. 30-34
Author(s):  
L. A. Katargina ◽  
E. V. Denisova ◽  
I. N. A. Bahaaeddin ◽  
M. A. Khrabrova
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Anterior Chamber Angle ◽  
Safe Method ◽  
Ahmed Valve ◽  
Valve Implantation ◽  
Chamber Angle

The purpose is to evaluate the effectiveness and safety of Ahmed valve implantation in children with refractory postuveitic glaucoma (PUG).Material and methods. Ahmed valve was implanted to 10 children aged 7 to 17 years (10 eyes) with open-angle or mixed PUG uncompensated even by a maximum antihypertensive mode. Previously, all patients had undergone an average of 2.1 ± 0.9 surgeries aimed at normalizing the intraocular pressure (IOP) (predominantly, sinus trabeculectomy). 6 eyes were pseudophakic, 2 phakic, 2 aphakic. Ahmed valves were implanted according to the generally accepted technique. At the time of surgery IOP was 30.50 ± 4.35 mm Hg on average. The follow-up postsurgical period ranged from 3.9 to 23.6 months (averagely, 14.1 ± 6.5).Results. A stable hypotensive effect of the intervention was achieved in 90 % of cases, of which 3 patients had no hypotensives while 6 patients received hypotensive drugs even though their quantity was significantly smaller than before surgery (1.7 ± 1.49, p=0.028). At the end of the follow-up the average IOP was 18.1 ± 5.34 mm Hg, (significantly lower than before surgery, p = 0.008). During surgery, 1 patient experienced bleeding from the vessels of the anterior chamber angle after paracentesis, which was stopped by tamponade with sterile air. In other cases, the surgery as well as the immediate and distant postoperative period showed no complications.Conclusion. Ahmed valve implantation is an effective and safe method of the surgical treatment of refractory PUG in children and can be recommended in cases when previous antiglaucomatous operations proved ineffective, including patients with pseudophakia and aphakia.

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