Phacoemulsification in Patients with Ahmed Glaucoma Valve Implant

PURPOSE: To investigate the effects of phacoemulsification in glaucomatous eyes with a functioning Ahmed glaucoma valve insertion. METHODS: This retrospective analysis followed 28 eyes from 26 patients with a functioning Ahmed glaucoma valve who had clear corneal phacoemulsification from December 1999 to February 2006. Intraocular pressure (IOP), best corrected visual acuity (BCVA), number of glaucoma medications and additional glaucoma surgeries were measured. RESULTS: The mean IOP before phacoemulsification was 17.4 mmHg +/- 5.8 (SD). Postoperative IOP was 13.6 +/- 4.4 mmHg, 13.7 +/- 4.0 mmHg, 14.1 +/- 4.0 mmHg and 15.4 +/- 3.8 mmHg at 1, 2, 6, and 12 months, respectively. The change in the number of glaucoma medications significantly changed at 1 month (p0.05) postoperatively. The IOP significantly changed at 1 week, 1 month, 2 months, and 6 months (p0.05) postoperatively. No eyes required additional surgery. BCVA improved in 23 eyes; the mean improvement was 3.7 +/- 2.9 Snellen lines at 2 months postoperatively. CONCLUSIONS: Phacoemulsification in glaucomatous eyes with a functioning Ahmed glaucoma valve improved BCVA and maintained control of IOP.

2,095 Cases of Intraocular Lens Implantation

We reviewed the 2,095 cases among the 3,000 cases who underwent the intraocular lens(IOL) implantation from the first trial of IOL in 1978 to 30 th June, 1986. The data was analyzed by Minicomputer(Honewell Level 6 Model 57, U.S.A.) Cobal Language. The results were as follows; 1. Among the 2,095 cases, primary implantation was over 98%. The trend toward the posterior chamber lens(PCL) was increased annually. 2. The most commonly implanted intraocular lens power was +19.5D. in PCL and +18.0D. in ACL. Modified J loop type of PCL was used in 86% of PCL implantation. 3. The corrected visual acuity of 20/30 or better at postoperative 6 month follow-up was 78% in PCL group, and 70% in ACL group. 4. The mean spherical equivalent within +/-1.0D. at postoperative 6 month was 48% in cases were measured IOL power with biometry, and 37% in cases without biometry. 5. The average corneal endothelial cell loss at postoperative 6 month was 13.08 +/- 1.08% in PCL group, and 22.20 +/- 1.90% in ACL group. 6. The late postoperative complications were about 8%. There were pupillary abnormalities(21%), glaucoma(11%), after cataract(20%) and clinical cystoid macular edema(5%). 7. The preoperative mean corneal curvature(K-reading), axial length and IOL power was 42.9D., 23.9 mm and +18.4D., respectively.