Risk factors for conjunctival tube erosion in eyes implanted with Ahmed glaucoma valve in a private eye institution in the Philippines

Objective@#To identify the risk factors for conjunctival tube erosion (CTE) in eyes implanted with Ahmed® glaucoma valve (AGV) device@*Method@#This is a retrospective study conducted at a private eye institution. Medical records of patients who underwent AGV implantation surgery from January 2004 to December 2013 were reviewed. Eyes with at least 24 months of follow-up and complete records were included. Several variables from the pre-, intra-, and postoperative periods were collected. The primary outcome was development of CTE after AGV surgery. Univariable logistic regression and multivariable analysis were employed.@*Results@#Forty-six (46) eyes of 45 patients were included in the study. The mean follow-up was 50.2 months (range: 24-140 months). Eight (8) eyes developed CTE (17.4%). Univariable logistic regression analysis identified female gender (P =0.064), presence of diabetes (P =0.083), prior intraocular surgeries (P =0.09), and postoperative use of antiglaucoma medications (P =0.086) to be marginally significant risk factors for CTE. On multivariable analysis, only female gender (OR=15.4, P =0.033) and diabetes (OR=14.1, P =0.031) were found to be significantly associated with CTE.@*Conclusion@#Risk factors for CTE following AGV implantation include female gender and presence of diabetes.

Should anterior segment imaging devices replace gonioscopy?

@#Glaucoma will continue to be the leading cause of irreversible blindness worldwide.1,2 A recent metaanalysis done by Tham and coworkers projected an increase of 74% in the total number of people with glaucoma, from 64.3 million in 2013 to 76 million by 2020, and to 111.8 million by the year 2040.2 With this recent forecast, Asia will have the greatest number of both primary open angle glaucoma and primary angle closure glaucoma (PACG), comprising 18.8 million (79.8%) and 9 million (58.4%) respectively.2 Since half of the world’s PACG will come from Asia, an effective reduction in the real incidence and prevention of visual loss from this devastating disease will depend on the accurate assessment of the anterior chamber angle and early detection of appositional closure