Comparison of Outcome of Trabeculectomy With Mitomycin C and Ahmed Valve Implantation for Uveitic Glaucoma

PURPOSE: To assess and compare the clinical outcomes of primary trabeculectomy with mitomycin C and Ahmed valve implantation for secondary open-angle glaucoma following uveitis. METHODS: This study was conducted retrospectively on 30 eyes of 25 patients with open-angle glaucoma secondary to uveitis that had undergone trabeculectomy with mitomycin C and 33 eyes of 24 patients that had undergone Ahmed valve implantation. The clinical outcome indicators used in this study were intraocular pressure (IOP), number of anti-glaucoma agents, surgical success rate and occurrence of complications. RESULTS: Mean IOP and surgical success rate in patients who had undergone trabeculectomy with mitomycin C after a 12 month postoperative period were 14.0+/-8.2 mmHg and 76.7%, respectively, while those of patients with Ahmed valve implantation were 13.2+/-7.7 mmHg and 81.8%. The data did not show clinical significance. There was greater risk of surgical failure in patients at a younger age and/or with diabetes mellitus in cases of having gone through trabeculectomy with mitomycin C. CONCLUSIONS: Both trabeculectomy with mitomycon C and Ahmed valve implantation can be considered as primary surgical treatments for patients with open-angle glaucoma secondary to uveitis. However, trabeculectomy with mitomycin C should only be applied to a limited extent in patients that are young and/or have diabetes mellitus.

Delayed Suprachoroidal Hemorrhage After Ahmed Valve Implantation for Neovascular Glaucoma

PURPOSE: To report the case of delayed suprachoroidal hemorrhage after Ahmed valve implantation in a neovascular glaucoma (NVG) patient. CASE SUMMARY: A 74-years-old male visited the hospital with ocular pain in the left eye. He had a history of vitrectomy and Intraocular lens (IOL) scleral fixation due to trauma in the left eye. NVG was diagnosed and Ahmed valve was implanted in his left eye. Three days later, hypotony occurred with all quadrant choroidal detachment. Next day, raised intraocular pressure (IOP) was checked and anterior chamber was flat on slit lamp examination. Vitreous hemorrhage and suprachoroidal hemorrhage were suspected. We performed anterior chamber formation with viscoelastics. The anterior chamber became deeper and hemorrhage gradually decreased. A month later, the patient visited us with severe ocular pain. Raised IOP and shallow anterior chamber due to moderate hyphema and anteriorly placed IOL were found. Retinal detachment was suspected on B-scan. Vitrectomy, IOL removal, silicone oil insertion, and Ahmed valve removal were performed. CONCLUSIONS: We report we experienced one patient of delayed suprachoroidal hemorrhage after Ahmed valve implantation and he had poor prognosis.

Comparison of Clinical Appearance of Pediatric Ocular Injury, According to Grade Level

PURPOSE: To compare the causes and clinical manifestations of pediatric ocular injuries according to grade level. METHODS: We retrospectively reviewed the medical records of 78 children, 15 years and younger, who had been hospitalized for pediatric ocular injuries, classified them into three groups according to grade level, and compared their clinical manifestations. RESULTS: Eighteen (23.1%) were preschoolers, 39 (50.0%) were elementary school students, and 21 (26.9%) were middle and high school students. The most common causes of injury included toys and household goods at home in the preschool group, toys and sporting activity at home and school in the elementary school group, and sporting activity at school in the middle and high school group. The incidence of ocular injury was higher in the 'without supervision group' (57.7%); however, in the preschool group, it was higher (72.2%) even in the 'supervision group' (P<0.05). In the preschool group, the incidence of perforating ocular injury (P<0.05) and the rate of surgical treatment (P<0.05) were higher than those of other groups. CONCLUSIONS: The causes and clinical manifestations of pediatric ocular injury were different according to school degree. The incidence of pediatric ocular injuries can be decreased more efficiently by recognizing these differences.

Utility of the Anterior Segment Optical Coherence Tomography for Measurements of Central Corneal Thickness

PURPOSE: To demonstrate the capability of anterior segment optical coherence tomography (OCT), to evaluate central corneal thickness (CCT) and to compare the results with those by Orbscan II and standard ultrasound (US) pachymetry. METHODS: One examiner measured the CCT of 44 normal eyes of 22 subjects using anterior OCT, Orbscan II, and US pachymetry. Non-contact measurements by anterior segment OCT and Orbscan II were performed first, followed by contact measurements using US pachymetry. Three consecutive measurements were taken with each method and the mean values and correlations were analyzed. RESULTS: The mean value of the CCT was 531.45+/-32.90 micrometer with anterior OCT, 537.11+/-32.21 micrometer with Orbscan II, and 548.18+/-34.17 micrometer with US pachymetry. There was no statistically significant difference among the values obtained by the 3 instruments (P>0.05). CCT measurements by anterior segment OCT were highly correlated with Orbscan II and US pachymetry (P<0.001) measurements. CONCLUSION: CCT measurements by anterior segment OCT are highly correlated with Orbscan II or US pachymetry measurements. Using non-contact anterior segment OCT, a closer examination of the anterior segment including the cornea is possible. The measurement of the CCT using anterior segment OCT is applicable because result values are similar to measurements by Orbscan II or US pachymetry.