Ahmed Glaucoma Valve Implant for Neovascular Glaucoma

We studied retrospectively the results of the Ahmed glaucoma valve implant surgery in 20 eyes with neovascular glaucoma. All cases were failed with medical or surgical glaucoma interventions. Mean follow-up period was 15.1 +/-14.9 months (3~56 months). The criteria for success included a postoperative intraocular pressure (IOP) of less than or equal to 21 mmHg and greater than or equal to 6 mmHg, and no additional glaucoma therapy or devastating visual complications. Mean IOP was significantly reduced from pre- operative 36.9 +/-5.2 mmHg to 17.6 +/-8.7 mmHg at the last visit. In respect with IOP control,success rate was 80%at final follow-up.The causes of failure were loss of light perception in 3 eyes (25%), inadequate IOP control in 2 eyes (10%), tube removal due to malfunction in 1 eye (5%). Complete success rate was 70%at a final follow-up.Complication included hyphema in 15 eyes,hypotony in 7 eyes, fibrous membrane formation and anterior synechiae in 3 eyes, tube obstruction in 2 eyes, flat anterior chamber in 1 eye, corneal decompensation in 1 eye, tube malposition in 1 eye, temporary choroidal detachment in 1 eye. These results indicate that Ahmed glaucoma valve implant for neovascular glaucoma can be a good successful IOP control device and comparable to the other drainage device.

A Case of Late Onset Bleb-Related Endophthalmitis after Trabeculectomy with Mitomycin C

Adjunctive use of Mitomycin C (MMC)in trabeculectomy has greatly improved the success rate. Trabeculectomy with MMC, however, has resulted in a cystic and thin-walled filtering bleb, which may be more susceptible to infection. Late onset bleb-related endophthalmitis developed in a glaucoma patient at 40 months after MMC trabeculectomy. Filtering bleb in this patient had been avascular, thin-walled and cystic prior to the occurrence of endophthalmitis. Patient complained of decreased visual acuity with ocular discomfort and conjunctival injection and showed a mucopurulent infiltrate within the bleb, hypopyon and vitritis. Visual acuity was hand motion. An intensive treatment included anterior chamber irrigation, lensectomy,par plana vitrectomy, intravitreal and subconjunctival antibiotics (vancomycin,gentamycin) injection and topical and systemic corticosteroid (dexamethasone) and antibiotics,which led to a resolution.

A Case of Phthiriasis Palpebrarum in Children

The majority of the crab louse is found in pubic hairs, but some of them will colonize axillary hairs, eyelashes, eyebrows and occasionally scalp hairs. In children crab louse may colonize the eyelashes and scalp hairs. The authors found a crab louse, Phthirus pubis and their nits on the eyelashes and scalp hiars of 25-months-old female who complained of foreign body and itching sensation of her right upper lid. Treatment is accomplished by careful mechanical removal of the louse and nits followed by the epilation and application of antibiotic eyedrops or ointments. We report a case of Phthiriasis palpebrarum in children.