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Intraluminal stenting versus external ligation of ahmed glaucoma valve in prevention of postoperative hypotony

International Journal of Ophthalmology(English edition) 2021年第10期14卷 1560-1564页

作者： Dina Abd Elfattah Faried Wagdy Tharwat Mokbel Hisham Elsorogy Abd-Elmonem A.Elhesy Mansoura Ophthalmic Center Faculty of MedicineMansoura UniversityMansoura 35516Egypt Menofia University Hospital Menofia UniversityMenofia 32511Egypt

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.

关键词： stenting ligation ahmed valve hypotony glaucoma

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Simultaneous pars plana vitrectomy,panretinal photocoagulation,cryotherapy,and ahmed valve implantation for neovascular glaucoma

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International Journal of Ophthalmology(English edition) 2021年第9期14卷 1396-1401页

作者： Carolina Bernal-Morales Marina Dotti-Boada Alvaro Olate-Perez Manuel J.Navarro-Angulo Laura Pelegrín Marc Figueras-Roca Institut Clínic d’Oftalmologia(ICOF) Hospital ClínicBarcelona 08028Spain August Pi i Sunyer Biomedical Research Institute(IDIBAPS) Barcelona 08028Spain

AIM:To describe and evaluate the efficacy of ahmed glaucoma valve implantation(AGV)combined with pars plana vitrectomy(PPV)in a single surgical act for the treatment of advanced neovascular glaucoma(NVG).METHODS:Retrospective observational case series included 51 eyes from 50 patients with severe NVG treated with PPV,AGV,and panretinal photocoagulation and/or cryotherapy in a single surgical act during a 13-year period(2005-2018).Preoperative,intraoperative and postoperative data at day 1 and months 1,3,6,21,and 24 were systematically collected.Definition of surgical success was stablished at IOP between 6 and 21 mm Hg with or without topical treatment.RESULTS:Main indications for surgery were NVG secondary to proliferative diabetic retinopathy(39.2%)and central retinal vein occlusion(37.3%).Mean(±SD)preoperative IOP was 42.0±11.2 mm Hg decreasing to 15.5±7.1 mm Hg at 12 mo and 15.8±9.1 mm Hg at 24 mo of follow up.Cumulative incidence of success of IOP control was 76.0%at first postoperative month,reaching 88.3%at 6 mo.Prevalence of successful IOP control at long term was 74.4%at 12 mo and 71.4%at 24 mo.Eye evisceration for unsuccessful NVG management was required in 1 case(2.0%).CONCLUSION:Combination of AGV implantation and PPV in a single act may be a suitable option for severe forms of NVG in a case-by-case basis for effective IOP control and a complete panretinal photocoagulation.

关键词： neovascular glaucoma ahmed valve pars plana vitrectomy panretinal photocoagulation cryotherapy

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