Application of single-pass four-throw releasable suture drainage tube ligation technique in Ahmed glaucoma valve implantation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the application of single-pass four-throw releasable suture drainage tube ligation technique in Ahmed glaucoma valve(AGV)implantation.METHODS: A total of 78 patients(78 eyes)with refractory glaucoma who underwent AGV implantation in the People's Hospital of Leshan from May 2020 to January 2022 were retrospectively analyzed. According to the treatment, the patients were divided into the modified AGV implantation group, with 43 patients(43 eyes)treated by modified AGV implantation, ligating the drainage tube with single-pass four-throw releasable suture, and the traditional AGV implantation group, with 35 patients(35 eyes)treated by traditional AGV implantation. Followed-up for 6mo, the intraocular pressure(IOP), success rate and complications were observed at 1d, 1 and 2wk and 1 and 6mo after operation.RESULTS: Postoperative IOP at all follow-up visits was significantly lower than that before surgery in both groups(all P<0.05). There was no significant difference in IOP between groups at all follow-up visits(all P>0.05). The incidence of shallow anterior chamber was 5% in the modified AGV implantation group and 23% in the traditional AGV implantation group at 1wk after surgery(P<0.05). At 6mo after operation, the overall success rate was 98% in modified AGV implantation group and 89% in the traditional AGV implantation group(P>0.05).CONCLUSION:During AGV implantation, ligation of drainage tube with single-pass four-throw releasable suture can effectively reduce IOP and reduce the incidence of shallow anterior chamber in early postoperative stage. Furthermore, the technique is safe and efficacious.

Clinical observation of Ahmed glaucoma valve implantation for refractory glaucoma by directly puncturing the sclerotic tunnel / 国际眼科杂志(Guoji Yanke Zazhi)

To observe the clinic effects and complication of Ahmed glaucoma valve(AGV) implantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases ( 44 eyes ) of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure ( lOP ) , visual acuity, and complication of post - operation were contrasted with those of pre-operation.RESULTS:The success rate was 84. 1%, the mean preoperative lOP in research group was 52. 1±10. 1mmHg, and the last follow up mean lOP was 15. 6 ± 6. 9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber ( 4 eyes ) , choroidal detachment ( 3 eyes), drainage tube shift (1 eye), hyphema (6 eyes), drainage tube blockage ( 1 eye ) , expulsive choroidal hemorrhage (1 eye), and fiber wrap of drainage tray (5 eyes) .CONCLUSlON:AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. lt avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. lt is an effective procedure for refractory glaucoma.