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Ahmed glaucoma valve in post-penetrating-keratoplasty glaucoma: a critically evaluated prospective clinical study.

Panda A, Prakash VJ, Dada T, Gupta AK, Khokhar S, Vanathi M - Indian J Ophthalmol (2011 May-Jun)

Bottom Line: The mean IOP decreased from 42.95 ± 10.24 to 17.69 ± 3.64 mmHg (P < 0.001) and the use of medications dropped from 2.92 to 0.39 (P < 0.001) after AGV implantation.There was no significant change in best corrected visual acuity, graft clarity, or graft thickness.Six device-related complications occurred after AGV implantations which were successfully managed with medical or minor surgical therapy.

View Article: PubMed Central - PubMed

Affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. anitap49@yahoo.com

ABSTRACT

Aim: The aim was to evaluate the outcome of Ahmed glaucoma valve (AGV) in post-penetrating-keratoplasty glaucoma (PKPG).

Materials and methods: In this prospective study, 20 eyes of 20 adult patients with post-PKPG with intraocular pressure (IOP) >21 mmHg, on two or more antiglaucoma medications, underwent AG (model FP7) implantation and were followed up for a minimum of 6 months. Absolute success was defined as 5 < IOP < 21 mmHg and qualified success as 5 < IOP < 21 mmHg with medications or minor procedures.

Results: The mean IOP decreased from 42.95 ± 10.24 to 17.69 ± 3.64 mmHg (P < 0.001) and the use of medications dropped from 2.92 to 0.39 (P < 0.001) after AGV implantation. The absolute success was achieved in 11 eyes and qualified success in 9. There was no significant change in best corrected visual acuity, graft clarity, or graft thickness. Six device-related complications occurred after AGV implantations which were successfully managed with medical or minor surgical therapy.

Conclusions: Postkeratoplasty refractory glaucoma managed by AGV implantation revealed a satisfactory outcome up to 6 months of follow-up.

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Related in: MedlinePlus

(a) Ultrasound biomicroscope showing peripheral anterior synechiae. (b) Ultrasound biomicroscope showing longitudinal section of Ahmed glaucoma valve tube. (c) Ultrasound biomicroscope showing cross section of Ahmed glaucoma valve tube
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Figure 1: (a) Ultrasound biomicroscope showing peripheral anterior synechiae. (b) Ultrasound biomicroscope showing longitudinal section of Ahmed glaucoma valve tube. (c) Ultrasound biomicroscope showing cross section of Ahmed glaucoma valve tube

Mentions: The number of medications used preoperatively varied from 2 to 4 (mean 2.92 ± 0.49) and that in the postoperative period was 0–2 (mean 0.39 ± 0.65); the difference was significant (P <0.001, using Wilcoxon's signed rank test). The presence of PAS, a predictive factor for the development of PKPG, was found to be present in all the eyes [Fig. 1]. Absolute success was achieved in 11 eyes and qualified success in 9 eyes. All eyes had control of IOP after AGV implantation at 6-month follow-up, with or without medications. Out of nine eyes, six were on one medication and three were on two medications for IOP reduction.


Ahmed glaucoma valve in post-penetrating-keratoplasty glaucoma: a critically evaluated prospective clinical study.

Panda A, Prakash VJ, Dada T, Gupta AK, Khokhar S, Vanathi M - Indian J Ophthalmol (2011 May-Jun)

(a) Ultrasound biomicroscope showing peripheral anterior synechiae. (b) Ultrasound biomicroscope showing longitudinal section of Ahmed glaucoma valve tube. (c) Ultrasound biomicroscope showing cross section of Ahmed glaucoma valve tube
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3120236&req=5

Figure 1: (a) Ultrasound biomicroscope showing peripheral anterior synechiae. (b) Ultrasound biomicroscope showing longitudinal section of Ahmed glaucoma valve tube. (c) Ultrasound biomicroscope showing cross section of Ahmed glaucoma valve tube
Mentions: The number of medications used preoperatively varied from 2 to 4 (mean 2.92 ± 0.49) and that in the postoperative period was 0–2 (mean 0.39 ± 0.65); the difference was significant (P <0.001, using Wilcoxon's signed rank test). The presence of PAS, a predictive factor for the development of PKPG, was found to be present in all the eyes [Fig. 1]. Absolute success was achieved in 11 eyes and qualified success in 9 eyes. All eyes had control of IOP after AGV implantation at 6-month follow-up, with or without medications. Out of nine eyes, six were on one medication and three were on two medications for IOP reduction.

Bottom Line: The mean IOP decreased from 42.95 ± 10.24 to 17.69 ± 3.64 mmHg (P < 0.001) and the use of medications dropped from 2.92 to 0.39 (P < 0.001) after AGV implantation.There was no significant change in best corrected visual acuity, graft clarity, or graft thickness.Six device-related complications occurred after AGV implantations which were successfully managed with medical or minor surgical therapy.

View Article: PubMed Central - PubMed

Affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. anitap49@yahoo.com

ABSTRACT

Aim: The aim was to evaluate the outcome of Ahmed glaucoma valve (AGV) in post-penetrating-keratoplasty glaucoma (PKPG).

Materials and methods: In this prospective study, 20 eyes of 20 adult patients with post-PKPG with intraocular pressure (IOP) >21 mmHg, on two or more antiglaucoma medications, underwent AG (model FP7) implantation and were followed up for a minimum of 6 months. Absolute success was defined as 5 < IOP < 21 mmHg and qualified success as 5 < IOP < 21 mmHg with medications or minor procedures.

Results: The mean IOP decreased from 42.95 ± 10.24 to 17.69 ± 3.64 mmHg (P < 0.001) and the use of medications dropped from 2.92 to 0.39 (P < 0.001) after AGV implantation. The absolute success was achieved in 11 eyes and qualified success in 9. There was no significant change in best corrected visual acuity, graft clarity, or graft thickness. Six device-related complications occurred after AGV implantations which were successfully managed with medical or minor surgical therapy.

Conclusions: Postkeratoplasty refractory glaucoma managed by AGV implantation revealed a satisfactory outcome up to 6 months of follow-up.

Show MeSH
Related in: MedlinePlus