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Purpose: To evaluate the prevalence of hypertensive phase (HP) and failure in patients who underwent Ahmed Glaucoma Valve (AGV) implantation and identify the possible risk factors for both HP and failure. Methods: A cross?sectional, observational study was conducted. Medical records of patients who underwent AGV implantation and had at least 1 year of follow?up were reviewed. HP was defined as an intraocular pressure (IOP) greater than 21 mmHg between the first week and the third postoperative month not attributable to other causes. Success was defined as an IOP between 6 and 21 mmHg, with preservation of light perception and no additional glaucoma surgeries. Statistical analysis was conducted to identify possible risk factors. Results: A total of 193 eyes of 177 patients were included. HP was present in 58%; a higher preoperative IOP and younger age were associated with HP. Pseudophakic or aphakic eyes had a lower HP rate. Failure was present in 29%; neovascular glaucoma, worse basal best corrected visual acuity (BCVA), higher baseline IOP, and postoperative complications were linked to a higher likelihood of failure. No difference in the HP rate between the failure and success groups was found. Conclusion: A higher baseline IOP and younger age are associated with HP development; pseudophakia and aphakia might be protective factors. Factors for AGV failure are a worse BCVA, neovascular glaucoma, postoperative complications, and a higher baseline IOP. At 1 year, a higher number of medications were needed to achieve IOP control in the HP group
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Purpose: To evaluate the outcome of glaucoma drainage device (GDD) insertion of tube through ciliary sulcus (CS) versus anterior chamber (AC) placement in the North Indian population Methods: This retrospective comparative case series included 43 patients in CS group and 24 in AC group, who underwent GDD implantation, from March 2014 to February 2020. The main outcome measures were intraocular pressure (IOP), number of anti?glaucoma medications, best corrected visual acuity (BCVA), and complications. Results: Sixty?seven eyes of 66 patients were included in study with mean follow?up of 25.04 months (range, 12–69 months) in the CS group and 17.4 months (range, 13–28 months) in the AC group. Preoperatively the two groups were similar except for postpenetrating keratoplasty glaucoma (PPKG) and pseudophakic patients, which were higher in the CS group (P < 0.05). Both groups showed statistically insignificant difference in postoperative IOP and BCVA at last follow?up (P = 0.173, P = 0.495, respectively). Postoperative complications were similar, except for corneal decompensation which was significantly higher in the AC group (P = 0.042). Conclusion: Our findings suggest that there was no statistically significant difference in mean IOP between the CS and AC groups at the last follow?up. CS placement of tube of GDD appears to be effective and safe technique. However, CS placement of tube resulted in lesser corneal decompensation and thus should be preferred in pseudophakic/aphakic patients, especially PPKG.
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Purpose: Comparison of the conjunctiva related complication rates and success rates among eyes with Ahmed glaucoma valve (AGV) implantation in which eye bank derived scleral and corneal patch grafts had been used to cover the tube. Methods: Retrospective comparative study. Patients who underwent AGV implantation between January 2000 to December 2016 were included. Demographic, clinical data, intra and post operative data was obtained from electronic medical records. Conjunctiva related complications were divided into two groups: with and without implant exposure. Conjunctiva related complication rates, success rate, risk factors among eyes with corneal and scleral patch graft were compared. Results: Three hundred and twenty three eyes of 316 patients underwent AGV implantation. Scleral patch graft was used in 214 eyes of 210 patients (65.9%) and corneal patch graft was used in 109 eyes of 107 patients (34%). Median follow up was 14 months. There was no significant difference in the conjunctiva related complication rate (7.3 % in corneal patch graft versus 7.0% in scleral patch graft;p=0.5) and conjunctival dehiscence rate (3.7% versus 4.6%, P = 0.7) among the two groups. Success rate was significantly higher in the corneal patch graft group versus the scleral patch graft group (98% versus 72%; p=0.001). Eyes with corneal patch graft had a higher survival rate (P = 0.01). Conclusion: There was no significant difference in the rate of conjunctiva related complications following corneal and scleral patch grafts used to cover the AGV tube. Eyes with corneal patch graft had a higher success rate and survival rate.
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AIM: To evaluate the efficacy of Ahmed glaucoma valve implanting through the ciliary sulcus in the treatment of intraocular lens(IOL)glaucoma.METHODS: Retrospective case series study. The clinical data of 18 patients(18 eyes)with IOL glaucoma from February 2020 to February 2022 in Liuzhou Red Cross Hospital were collected. All patients underwent Ahmed glaucoma valve implanting through the ciliary sulcus. The visual acuity, intraocular pressure, corneal endothelial cell density, corneal endothelial cell loss rate and complications were observed before operation and 1, 3, 6 and 12mo after operation.RESULTS: The mean intraocular pressure before operation was 43.41±5.33 mmHg. The mean intraocular pressure at 1, 3, 6 and 12mo after operation were 12.11±3.26, 13.82±4.12, 13.54±3.83 and 15.80±4.35 mmHg respectively. The mean intraocular pressure at each follow-up point after operation was significantly lower than that before operation(F=203.40, P<0.01). The corneal endothelial cell density at each time point after surgery was lower than that before surgery(F=6.18, P<0.01), but there were no significantly differences in the density and loss rate of corneal endothelial cell at 1, 3, 6 and 12mo after surgery(P>0.05). Furthermore, the overall surgery success rate was 83%.CONCLUSIONS: Ahmed glaucoma valve implanting through the ciliary sulcus is safe and effective in the treatment of IOL glaucoma, and the damage to corneal endothelial cells is mild. The corneal endothelial cells density doesn't decrease with time after surgery.
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Purpose: To evaluate the incidence of shallow anterior chamber in the early postoperative period following Ahmed glaucoma valve (AGV) implantation and its effect on the hypertensive phase (HP), intermediate-term intraocular pressure (IOP) control, and success rate. Methods: A retrospective analysis of 369 eyes of 360 patients who underwent AGV implantation between January 2005 and January 2020 with a minimum follow-up of 2 months was performed. Twenty-six patients developed shallow anterior chamber (AC) within 8 weeks following surgery (cases). They were compared with 39 randomly selected controls (no shallow AC post AGV). HP (IOP spike >21 mmHg), use of ocular hypotensive medications, and other associations were compared. Results: Incidence of shallow AC post AGV was 7% (95% confidence interval [CI] 4, 9). The onset of shallow AC was 3 ± 2.1 days and resolved within 6 ± 4.7 days. Hypotony (12 [47%] vs. 1 [2.5%], P 0.0001) and choroidal detachment (CD; 7 [27%] vs. 3 [8%], P 0.03) were more common in cases compared to controls. The HP occurred in 11 (43%) cases versus 13 (34%) controls (P 0.4). Cases required more ocular hypotensive medications than controls at the end of 8 weeks (1.1 ± 1 vs. 0.5 ± 0.5, P 0.01). There was no significant difference in the qualified success between the groups at 1 year. Conclusion: The development of postoperative shallow AC post AGV implantation was not detrimental to IOP control at 1 year. However, there is a need to monitor the occurrence of HP in these eyes.
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The presence of emulsified silicone oil in the eye can lead to many complications, glaucoma being one of the most common. Adequate IOP control is difficult to achieve with medical management alone; surgical intervention is often required. Glaucoma drainage device implantation is often the preferred line of surgical intervention in such cases due to trabeculectomy failure from emulsified silicone oil droplets and associated conjunctival scarring. However, the silicone tube of Ahmed glaucoma valve (AGV) may attract the silicone oil droplets, causing blockade of the tube with persistent raised IOP postoperatively. We report one such case where post?AGV silicone oil tube occlusion was treated with semi?conservative surgical management instead of revising the entire surgery or implantation of another drainage device. Our surgical technique of intracameral “vent and flush” offers rapid and effective IOP control in such cases. Postoperatively, normal IOP was achieved. Patency of tube continued to be maintained along with normalization of IOP on subsequent follow?ups.
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Purpose: To determine the outcomes of Ahmed glaucoma valve (AGV) and transscleral diode cyclophotocoagulation (CPC) in neovascular glaucoma (NVG). Methods: This was a single?center retrospective comparative case series involving chart review of consecutive patients who underwent AGV or CPC for treatment of NVG and had ?6 months of follow?up. Surgical failure at 6 months, defined as an IOP of >21 or <6 mm Hg with hypotony maculopathy after 1 month, progression to no light perception (NLP) vision, glaucoma reoperation, or removal of AGV were the main outcome measures. Results: In total, 121 eyes of 121 patients were included (70 AGV and 51 CPC). Baseline demographics, visual acuity (VA), and intraocular pressure (IOP) were comparable between groups. At 6 months, failure was significantly higher in the CPC group than in the AGV group (43.1% vs. 17.1%, P = 0.020). Both groups had similar IOP and medication number at 6 months, but VA was significantly lower in the CPC group compared to the AGV group (2.4 � 0.8 vs. 1.9 � 1.0, P = 0.017). More CPC eyes required reoperation for glaucoma than AGV eyes (11.8% vs. 1.4%, P = 0.041). Multivariate regression analysis identified higher preoperative IOP (P = 0.001) and CPC surgery (P = 0.004) as independent predictors of surgical failure at 6 months. Age, sex, race, NVG etiology, bilaterality of the underlying retinal pathology, perioperative retina treatment, and prior or combined vitrectomy were not significant. Conclusion: AGV and CPC had comparable IOP and medication reduction in NVG eyes at 6 months. CPC was more frequently associated with failure, reoperation for glaucoma, and worse visual outcomes. High preoperative IOP and CPC surgery independently predicted surgical failure.
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Purpose: To report the outcomes of pars plana insertion of Aurolab aqueous drainage implant (AADI) in adults with refractory glaucoma by the novel technique of making scleral tunnel instead of patch graft to cover the tube to prevent its migration. Methods: A retrospective study was done between April 2016 and April 2018 on patients with ?12 months of follow?up. The main outcome measure was a surgical failure at 12 months. The failure was defined as intraocular pressure (IOP) >18 mmHg or IOP ?5 mmHg on two consecutive follow?up visits after 3 months, reoperation for glaucoma, loss of light perception vision, or implant explantation. Alternate definitions of failure including IOP >21 and IOP >15 mmHg were also considered. Results: The study included 32 eyes of 32 patients. The mean age was 46.2 ± 17.5 years. The most common etiology is traumatic glaucoma (12 eyes, 37.5%). The mean preoperative IOP and anti?glaucoma medications were 43.3 ± 10.3 and 3.4 ± 0.5 mmHg, respectively; both the parameters at the final follow?up were reduced to 15.2 ± 8.1 and 1.6 ± 0.5 mmHg. The Kaplan–Meier survival estimates demonstrated that the cumulative probability of failure was 15.6% (95% CI; 6.8–33.5%) at 3 months, 18.7% (95% CI; 8.9–37.0%) at 6 months, and 25.0% (95% CI; 13.4–43.8%) at 12 months. Conclusion: Pars plana AADI implantation with a newer modification technique is a useful procedure in reducing IOP and the number of anti?glaucoma medications in the eyes with refractory glaucoma. The visual acuity may be stabilized with the concurrent treatment of posterior segment pathology
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@#AIM: To observe the clinical therapeutic efficacy of Ahmed glaucoma valve(AGV)implantation with intravitreal injection of aflibercept or ranibizumab in patients with neovascular glaucoma(NVG). <p>METHODS: A retrospective study. The clinical data of 33 cases(33 eyes)with NVG angle-closure glaucoma who were received intravitreal injection of aflibercept or ranibizumab with AGV implantation from January 2018 to August 2020 in our hospital were involved in this study. There were 18 eyes in the aflibercept group and 15 eyes in the ranibizumab group. All patients were followed-up for 6mo. The best-corrected visual acuity(BCVA), intraocular pressure, neovascularization, and postoperative complications were recorded and evaluated.<p>RESULTS: Before the first intravitreal injection and 1wk after intravitreal injection, the differences of intraocular pressure and BCVA in two groups were not statistically significant(<i>P</i>>0.05); The changes of intraocular pressure and BCVA before the first intravitreal injection and after AGV implant 1wk, 1, 3, 6mo were statistically significant in two groups(<i>P</i><0.01), but there were no statistically significant differences intraocular pressure and BCVA between the two groups at each follow-up time point(<i>P</i>>0.05). There were no significant differences in average number of injections between aflibercept group(1.61±0.98)and ranibizumab group(1.80±0.86)(<i>P</i>>0.05). The differences of neovascular recurrence rate, incidence of early and late complications and surgical success rates were not statistically significant(<i>P</i>>0.05).<p>CONCLUSION: Intravitreal aflibercept or ranibizumab injection combined with AGV implantation is an effective treatment for NVG. The clinical efficacy of aflibercept and ranibizumab were similar.
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@#AIM: To investigate the therapeutic effect of conbercept injection combined with Ahmed valve implantation and phacoemulsification in the treatment of neovascular glaucoma(NVG).<p>METHODS: Retrospective analysis. Totally 18 patients(18 eyes)with NVG complicated combined with cataract in our hospital from June 2018 to January 2020. All patients received intraocular injection of conbercept at 3-7d before surgery, Ahmed valve implantation and phacoemulsification were performed after meeting the surgical indications. Best corrected visual acuity(BCVA), intraocular pressure(IOP), resolution of iris neovascularization and postoperative complications were followed up after the surgery, and all the cases were followed up 12mo. <p>RESULTS: Compared with preoperation(51.44±8.18 mmHg), IOP was significant decreased at 1, 7d, 1, 3, 6mo, 1a after surgery(25.94±11.82, 15.39±4.97, 15.94±2.69, 15.33±4.54, 18.89±7.95, 16.27±5.22 mmHg)(<i>P</i><0.05). Last follow up after surgery, BCVA was improved in 12 eyes(67%), unchanged in 5 eyes(28%)and decreased in one eye. At 1a after operation, the complete success rate was 83%(15 eyes), conditional success rate was 11%(2 eyes), one eye of losing control of IOP was failed. <p>CONCLUSION: Conbercept intraocular injection combined with Ahmed valve implantation and phacoemulsification can not only effectively control postoperative IOP, but also improve the visual acuity of the patients as much as possible. It is an effective method for the treatment of NVG with cataract.
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Objective:To investigate the effectiveness and safety of the allogeneic corneal stromal flap in reducing the exposure of the drainage catheter in the implantation of Ahmed glaucoma valve.Methods:Fifty-three patients(61 eyes) with refractory glaucoma treated by Ahmed glaucoma valve implantation from January 2017 to April 2019 were retrospectively analysed. The patients were divided into sclera tunnel group(routine group) and sclera tunnel with allogeneic corneal stroma flap covering(improved group). The cumulative success rate of surgery, preoperative intraocular pressure(IOP), IOP at the last outpatient follow-up, the best-corrected visual acuity(BCVA), BCVA at the last outpatient follow-up, drainage catheter exposure and other surgical complications were collected from both groups at 6, 12 and 24 months after surgery. The data between the 2 groups were statistically analyzed, P<0.05 was statistically significant. Results:The cumulative success rates of 6, 12 and 24 months after operation were 89.7%, 86.2% and 69.0% in the routine group, and 90.6%, 90.6% and 71.8% in the improved group, respectively. There was no significant differences between the 2 groups( P>0.05). The IOP and BCVA at the final follow-up were significantly improved in both groups, with a statistical significant difference( P<0.05). In the conventional group, the exposure of drainage catheter occurred in 4 eyes(13.8%). Further surgeries were carried out to cover the exposed drainage catheters with allogeneic corneal stroma flaps and amniotic membrane and all had good recovery. There was no drainage catheter exposure in the improved group. The difference between the 2 groups was statistically significant( χ2=4.724, P=0.030). There was no significant difference in other surgical complications between the 2 groups( χ2=0.160, P=0.689). No intraoperative or postoperative complications regarding the corneal stromal flap were observed. Conclusion:Implantation of Ahmed glaucoma valve with allogeneic corneal stromal flap sealing can effectively reduce the exposure of the drainage catheter. It is a safe method.
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SUMMARY: The aim of the study was to determine the number and anatomical configuration of roots and root canals of maxillary first and second premolars using cone-beam computed tomography scans. n273 CBCT scans were evaluated, obtaining a sample of 592 maxillary premolars. Root number and root canal anatomy were categorized using Ahmed´s classification. Data was analyzed using Pearson's Chi-squared test. Two roots were present on 157 first premolars, one root in 132 premolars and three roots in 17. Second premolars presented one root in 266 samples and two roots in 20; no second premolars presented three roots. Eight different configurations were found; the most frequent was 2MP B1 P1 in first premolars (51,3 %) and 1MP1 (63.6 %) in second premolars. The most frequent morphology found in maxillary premolars in Chilean population was two and three roots. The analysis of internal anatomy using CBCT revealed a highly variable distribution of root canals, generally of low to medium complexity, similar to what is found in other ethnic groups.
RESUMEN: El objetivo de este estudio fue determinar el número y la configuración de raíces y canales radiculares de primeros y segundos premolares maxilares utilizado tomografía computacional de haz cónico. 273 TCHC fueron evaluados, obtenido una muestra de 592 premolares maxilares. El número de raíces y la anatomía de los canales radiculares fueron categorizados utilizando la clasificación de Ahmed. Los datos fueron analizados con la prueba Chi- Cuadrado de Pearson. Dos raíces fueron observadas en 157 primeros presentaron una raíz en 266 muestras y dos raíces en 20; no se encontraron tres raíces en segundos premolares. Ocho diferentes configuraciones fueron encontradas; siendo la más frecuente 2MP B1 P1 en primeros premolares (51,3 %) y 1MP1 (63,6 %) en segundos premolares. La morfología radicular más frecuentemente encontrada en premolares de población Chilena fue de dos y tres raíces. El análisis de la anatomía interna usando TCHC mostró una gran variabilidad de en la distribución de los canales radiculares. Generalmente de mediana y baja complejidad como los encontrados en otros grupos etnicos.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Tooth Root/diagnostic imaging , Bicuspid/diagnostic imaging , Cone-Beam Computed Tomography , Maxilla/diagnostic imaging , Tooth Root/anatomy & histology , Bicuspid/anatomy & histology , Cross-Sectional Studies , Maxilla/anatomy & histologyABSTRACT
Resumen Introducción: El glaucoma es una enfermedad que afecta al ojo y se caracteriza por la lesión tanto del nervio óptico como de la retina, relacionados con el aumento de la presión intraocular. La detección el tratamiento adecuado ayuda a ofrecer una mejor calidad de vida al paciente. Objetivo: Comparar la presión intraocular posoperatoria entre la trabeculectomía y la derivación con válvula Ahmed en pacientes con glaucoma primario de ángulo abierto del Hospital Central Militar de Enero del 2017 a Enero de 2018. Material y método: Es un estudio observacional, descriptivo y retrospectivo, de pacientes diagnosticados con glaucoma primario de ángulo abierto atendidos en la consulta de oftalmología en el Hospital Central Militar de enero de 2017 a enero del 2018, en quienes se empleó como herramienta de trabajo sus expedientes clínicos electrónicos, utilizando el programa R versión 3.4.4 (R Foundation for Statistical Computing, Vienna, Austria). Resultados: Se identificaron un total de 100 pacientes en el periodo de estudio. Los pacientes presentaron una edad entre 32 y 93 años. El 35 % de los pacientes fueron sometidos a trabeculectomía y el 65 % restante fueron sometidos a derivación con válvula Ahmed donde se observó una mayor reducción con la válvula Ahmed en pacientes con mayor presión prequirúrgica. Conclusiones: Podemos concluir que la derivación con válvula Ahmed resulta en mejores resultados postoperatorios, los cuales se observan después de la segunda consulta de seguimiento, por lo cual esta técnica trae mejores resultados a manejos de la PIO de los pacientes que requieren tratamiento quirúrgico, a pesar de que la trabeculectomía sea el estándar de oro ya no representa mayores beneficios que utilizar una técnica menos invasiva como lo es la válvula Ahmed. Así mismo, la trabeculectomía regula mejor las presiones intraoculares en aquellos pacientes que no tienen tanto aumento de la PIO.
Abstract Introduction: Glaucoma is a disease that affects the eye and at the same time the injury as well as the optic nerve and the retina, related to the increase in intraocular pressure. The detection of adequate treatment helps to offer a better quality of life to the patient. Objective: To compare the postoperative intraocular pressure between the trabeculectomy and the Ahmed valve shunt in patients with primary open angle glaucoma of the Central Military Hospital from January 2017 to January 2018. Material and method: It is an observational, descriptive and retrospective study, patients diagnosed with glaucoma. his electronic clinical records, using the R program version 3.4.4 (R Foundation for Statistical Computing, Vienna, Austria). Results: A total of 100 patients were identified during the study period. The patients present an age between 32 and 93 years. 35% of the patients underwent a trabeculectomy and the remaining 65% underwent a bypass with the Ahmed valve where a greater reduction was observed with the Ahmed valve in patients with higher presurgical pressure. Conclusions: We can conclude that the derivation with the Ahmed valve results in better postoperative results, which are observed after the second follow-up visit, so this technique brings better results to the IOP management of patients who require treatment. surgical, a The work is not related to the use of a less invasive technique. Likewise, trabeculectomy better regulates intraocular pressures in those patients who do not have such an increase in IOP.
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@#AIM:To assess the efficacy of Ahmed glaucoma valve implantation combined with lens extraction for neovascular glaucoma(NVG)with cataract.<p>METHODS: A retrospective comparative study was designed. 93 patients with NVG were enrolled. All patients received preoperative anti-vascular endothelial growth factor(VEGF)injections, 41 eyes underwent Ahmed glaucoma valve(AGV)implantation only, and 52 eyes underwent AGV implantation and lens extraction by phacoemusification. The best corrected visual acuities(BCVA), intraocular pressure(IOP), and surgical complications were evaluated.<p>RESULTS: Postoperative visual acuity was improved in 16 eyes(39%), decreased in 14 eyes(34%), unchanged in 11 eyes(27%)in group 2, and 15 eyes(29%)improved,24 eyes(46%)decreased, 13 eyes(25%)unchanged in group 1 respectively(<i>P</i>>0.05). The group 2 demonstrated an 51% complete and 22% qualified success rate and 27% failure rate, and the 44% complete and 25% qualified success rate and 31% failure rate in group 1(<i>P</i>>0.05). Among the complications, fibrous exudation(56%)was the first, hyphema(46%)came second in group 2, while shallow anterior chamber(35%)was the most, fibrous exudations(31%)and anterior chamber hyphema(25%)followed in the group 1. And no tube extrusion serious complication had occurred in both groups(<i>P</i><0.05). No significant differences in postoperative complications were observed between the groups(<i>P</i>>0.05).<p>CONCLUSION: For NVG with cataract, AGV implantation with lens extraction is a priority for reduction of IOP and improvement of visual acuity.
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We describe a case of 34-year-old male with post penetrating keratoplasty glaucoma, post trabeculectomy with aphakia in the only seeing eye, in which a modified surgical technique of inserting Ahmed glaucoma valve (AGV) tube in vitreous cavity was done to reduce the risks associated with pars plana incision during pars plana vitrectomy (PPV). A hybrid 20-25 gauge PPV was done concurrently, implant fixed to sclera, and tube inserted through the 25 gauge sclerotomy port in supero-temporal quadrant. Visual acuity and intraocular pressure remained stable during 1-year follow-up.
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@#AIM: To investigate the effect of modified Ahmed drainage valve implantation combined conbercept in the treatment of neovascular glaucoma.<p>METHODS: Neovascular glaucoma patients(59 cases, 60 eyes)were separated into experiment group(20 cases, 21 eyes)and control group(39 cases, 39 eyes)in our hospital from 2015 to 2018. Patients in the experiment group received Ahmed drainage valve implantation and intravitreal conbercept injection while patients in the control group were treated with ciliarybody photocoagulation. The visual acuity, intraocular pressure and iris neovessels were observed in 3mo after operation.<p>RESULTS: There was no significantly difference in the preoperative data between the two groups and both of them can decrease intraocular pressure(<i>P</i><0.05). The intraocular pressure of experiment group was significantly lower than that of control group in 1wk, 1mo and 3mo after treatment(all <i>P</i><0.05). The iris neovessels disappeared in experiment group, which was significantly different from that in control group(<i>Z</i>=2.74,<i>P</i><0.05). <p>CONCLUSION: Modified Ahmed drainage valve implantation combined with intravitreal conbercept injection can effectively decrease the intraocular pressure for a long time and make the iris neovessels vanish.
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@#AIM: To evaluate the effectiveness and safety of intravitreal injection of ranibizumab combined with Ahmed drainage valve implantation compared to pure Ahmed drainage valve implantation in the treatment of NVG.<p>METHODS: Computers were used to search PubMed, EMbase, Cochrane Library, American Scientific Citation Index Database(SCI), China Knowledge Network(CNKI), Chinese Science and Technology Journal Database(VIP), Wanfang Database, China Biomedical Document Service System(CBM), and to find literature about ranibizumab and Ahmed drainage valve implantation in the treatment of NVG. At the same time, relevant references were consulted. The search time limit was establishment until March 20, 2020. Quality evaluation and data extraction on the included studies were performed. RevMan 5.3 and STATA 12.0 software were used for Meta-analysis.<p>RESULTS: The included 7 clinical studies included 346 patients(349 eyes), and the quality was evaluated as medium to high quality. The homogeneity of the basic characteristics of various studies was better. Compared with the pure Ahmed drainage valve implantation group(the control group), the ranibizumab combined with Ahmed drainage valve implantation group(the experimental group)had lower intraocular pressure at 1wk and 1mo after surgery. There was no statistical difference at 6mo after surgery. The BCVA of the experimental group was better than that of the control group at 1mo and 3mo, and there was no significant difference at 6mo after surgery. There was no significant difference in the rate of anterior chamber bleeding and the number of anti-glaucoma drugs used between the two groups.<p>CONCLUSION: Compared with pure Ahmed drainage valve implantation, ranibizumab combined with Ahmed drainage valve implantation has better postoperative intraocular pressure and best corrected visual acuity in the early stage in the treatment of NVG, and the difference in the late postoperative period is not significant. It cannot reduce the rate of postoperative anterior chamber bleeding, and cannot reduce the use of anti-glaucoma drugs. This conclusion needs to be further confirmed by more high-quality clinical randomized controlled studies.
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RESUMEN Objetivo: Determinar los resultados del implante dispositivo de glaucoma de Ahmed en pacientes con glaucoma pediátrico refractario. Métodos: Se realizó un estudio de serie de casos en 15 pacientes (17 ojos) con glaucoma pediátrico refractario atendidos en el Servicio de Oftalmología Pediátrica del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de enero del año 2011 a enero de 2016, a quienes se les implantó una válvula de Ahmed y fueron seguidos por un periodo de 3 años. Se evaluaron la agudeza visual, la presión intraocular pre y posoperatoria, el éxito completo, el éxito calificado, las complicaciones y las reintervenciones. Resultados: La mediana de edad de los pacientes fue de 4,0 años y predominó el sexo masculino (58,8 por ciento). La media de la presión intraocular preoperatoria fue de 37,3 mmHg y disminuyó a 19,4 mmHg de manera significativa (p= 0,000) en el posoperatorio. El análisis de supervivencia global mostró una probabilidad acumulada de éxito completo de 94,1 por ciento al 1,5 mes, 70,6 por ciento a los 12 meses, 58,8 por ciento a los 18 meses, y 47,1 por ciento a los 24 y a los 36 meses. La de éxito calificado fue de: 94,1 por ciento a los 12 meses, 82,4 por ciento a los 18 meses, y 76,5 por ciento a los 24 y a los 36 meses. La frecuencia de complicaciones fue de 29,4 por ciento y la de reintervenciones de 23,5 por ciento. Conclusiones: El implante de válvula de Ahmed en el glaucoma pediátrico refractario es una indicación para la reducción de la presión intraocular(AU)
ABSTRACT Objective: Determine the results of Ahmed glaucoma valve implantation in patients with pediatric refractory glaucoma. Methods: A case-series study was conducted of 15 patients (17 eyes) with pediatric refractory glaucoma attending the pediatric ophthalmology service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from January 2011 to January 2016. These patients underwent Ahmed valve implantation and were followed up for a period of three years. Evaluation was performed of visual acuity, pre- and post-operative intraocular pressure, complete success, qualified success, complications and reinterventions. Results: Mean age of patients was 4.0 years, with a predominance of the male sex (58.8 percent). Mean preoperative intraocular pressure was 37.3 mmHg, significantly decreasing to 19.4 mmHg (p= 0.000) in the postoperative period. Overall survival analysis revealed a cumulative probability of complete success of 94.1 percent at 1.5 months, 70.6 percent at 12 months, 58.8 percent at 18 months and 47.1 percent at 24 and 36 months. Cumulative probability of qualified success was 94.1 percent at 12 months, 82.4 percent at 18 months and 76.5 percent at 24 and 36 months. The rate of complications and reinterventions was 29.4 percent and 23.5 percent, respectively. Conclusions: Indication of Ahmed valve implantation in pediatric refractory glaucoma is aimed at reducing intraocular pressure(AU)
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Humans , Male , Child, Preschool , Glaucoma/surgery , Glaucoma Drainage Implants/adverse effects , Intraocular Pressure , Case ReportsABSTRACT
@#AIM: To evaluate the effect of Ahmed glaucoma drainage valve implantation and leizumab on neovascularization glaucoma. <p>METHODS: Totally 80 patients(80 eyes)of neovascularization glaucoma(NVG)according to random number table method were divided into 34 cases(34 eyes)of control group and 46 cases(46 eyes)of research group, the control group was treated with Ahmed glaucoma drainage valve implantation, the research group was treated with Ahmed glaucoma valve implantation combined with rezuzumab, clinical curative effect, cytokines, intraocular pressure, vision after 6mo, and complications in both group were compared. <p>RESULTS: Six months after surgery, the total success rate of operation in the research group was higher than that in the control group(<i>P</i><0.05). 4d before surgery, there were no significant differences in intraocular pressure between the two groups(<i>P</i>>0.05). 7d after surgery, intraocular pressure in both groups all decreased, and the research group was lower than that in the control group(<i>P</i><0.05). 6mo after surgery, the improvement rate of vision in the research group was higher than that in the control group(<i>P</i><0.05). Within 6mo of follow-up, the drainage tube obstruction and hyphema rate in the research group were lower than those in the control group(<i>P</i><0.05). There was no difference in corneal edema, anterior chamber exudation, eyeball pain, shallow anterior chamber and low intraocular pressure rate between the two groups(<i>P</i>>0.05).<p>CONCLUSION:Ahmed glaucoma drainage valve implantation combined with rezumab injection can reasonably control intraocular pressure and improve visual function of patients. It is a safe and effective treatment scheme for NVG patients.