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Evaluation of Ahmed glaucoma valve implantation through a needle-generated scleral tunnel in Mexican children with glaucoma.

Albis-Donado O, Gil-Carrasco F, Romero-Quijada R, Thomas R - Indian J Ophthalmol (2010 Sep-Oct)

Bottom Line: Tube-related complications included five retractions, a lens touch and a transitory endothelial touch.The risk of failure increased if the eye had any complication or previous glaucoma surgeries.There were no tube extrusions, nor any tube exposures with this technique.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Glaucoma, Asociacion Para Evitar la Ceguera en México, DF, Mexico.

ABSTRACT

Purpose: To evaluate the results and extrusion rates of the Ahmed glaucoma valve (AGV) implantation through a needle-generated scleral tunnel, without a tube-covering patch, in children.

Materials and methods: A retrospective review of the charts of 106 Mexican children implanted with 128 AGVs operated between 1994 and 2002, with the needle track technique, at our institution, with at least six months follow up was done. Main outcome measures were intraocular pressure (IOP) control, tube extrusions or exposure and other complications.

Results: Kaplan-Meier analysis demonstrated a 96.9% survival rate at six months, 82.4% at one year, 78.7% at two years, 70% at three years and 41.6% at four years. Total success at the last follow-up (IOP between 6 and 21 mm Hg without medications) was achieved in 30 eyes (23.5%), 58 eyes (45.3%) had qualified success (only topical hypotensive drugs) and 40 eyes (31.3%) were failures. The mean pre- and post-operative IOP at the last follow up was 28.4 mmHg (SD 9.3) and 14.5 mmHg (SD 6.3), respectively. No tube extrusions or exposures were observed. Tube-related complications included five retractions, a lens touch and a transitory endothelial touch. The risk of failure increased if the eye had any complication or previous glaucoma surgeries.

Conclusion: Medium-term IOP control in Mexican children with glaucoma can be achieved with AGV implantation using a needle-generated tunnel, without constructing a scleral flap or using a patch to cover the tube. There were no tube extrusions, nor any tube exposures with this technique.

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Related in: MedlinePlus

Cumulative probability of success through follow-up time (Kaplan-Meier survival curve). The number of cases remaining without failure events is shown in boxes
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Figure 0001: Cumulative probability of success through follow-up time (Kaplan-Meier survival curve). The number of cases remaining without failure events is shown in boxes

Mentions: Kaplan-Meier analysis [Fig. 1] revealed a qualified and complete success rate of 96.9% at six months; 82.4% at one year, 78.7% at two years, 70% at three years and 41.6% at four years. From this point on less than 20 patients (15.75% of the original group) with more than four years of follow-up remained, and four more failures developed at 54, 60, 63 and 72 months of follow-up, making the cumulative survival drop to 28.5% at 96 months. The mean survival time for the whole group was 55.26 months (CI 46.6 – 63.9).


Evaluation of Ahmed glaucoma valve implantation through a needle-generated scleral tunnel in Mexican children with glaucoma.

Albis-Donado O, Gil-Carrasco F, Romero-Quijada R, Thomas R - Indian J Ophthalmol (2010 Sep-Oct)

Cumulative probability of success through follow-up time (Kaplan-Meier survival curve). The number of cases remaining without failure events is shown in boxes
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992909&req=5

Figure 0001: Cumulative probability of success through follow-up time (Kaplan-Meier survival curve). The number of cases remaining without failure events is shown in boxes
Mentions: Kaplan-Meier analysis [Fig. 1] revealed a qualified and complete success rate of 96.9% at six months; 82.4% at one year, 78.7% at two years, 70% at three years and 41.6% at four years. From this point on less than 20 patients (15.75% of the original group) with more than four years of follow-up remained, and four more failures developed at 54, 60, 63 and 72 months of follow-up, making the cumulative survival drop to 28.5% at 96 months. The mean survival time for the whole group was 55.26 months (CI 46.6 – 63.9).

Bottom Line: Tube-related complications included five retractions, a lens touch and a transitory endothelial touch.The risk of failure increased if the eye had any complication or previous glaucoma surgeries.There were no tube extrusions, nor any tube exposures with this technique.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Glaucoma, Asociacion Para Evitar la Ceguera en México, DF, Mexico.

ABSTRACT

Purpose: To evaluate the results and extrusion rates of the Ahmed glaucoma valve (AGV) implantation through a needle-generated scleral tunnel, without a tube-covering patch, in children.

Materials and methods: A retrospective review of the charts of 106 Mexican children implanted with 128 AGVs operated between 1994 and 2002, with the needle track technique, at our institution, with at least six months follow up was done. Main outcome measures were intraocular pressure (IOP) control, tube extrusions or exposure and other complications.

Results: Kaplan-Meier analysis demonstrated a 96.9% survival rate at six months, 82.4% at one year, 78.7% at two years, 70% at three years and 41.6% at four years. Total success at the last follow-up (IOP between 6 and 21 mm Hg without medications) was achieved in 30 eyes (23.5%), 58 eyes (45.3%) had qualified success (only topical hypotensive drugs) and 40 eyes (31.3%) were failures. The mean pre- and post-operative IOP at the last follow up was 28.4 mmHg (SD 9.3) and 14.5 mmHg (SD 6.3), respectively. No tube extrusions or exposures were observed. Tube-related complications included five retractions, a lens touch and a transitory endothelial touch. The risk of failure increased if the eye had any complication or previous glaucoma surgeries.

Conclusion: Medium-term IOP control in Mexican children with glaucoma can be achieved with AGV implantation using a needle-generated tunnel, without constructing a scleral flap or using a patch to cover the tube. There were no tube extrusions, nor any tube exposures with this technique.

Show MeSH
Related in: MedlinePlus