Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy. METHODS: Thirty - six patients (36 eyes) with prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure ( IOP), best corrected visual acuity (BCVA) and complications were ovserved and all the patients were followed up at least for 12mo. RESULTS: Mean preoperative IOP was 35. 20±7. 28mmHg and reduced to 10. 15±3. 34, 11. 23±3. 56, 15. 63±5. 72, 17. 17±5. 47, 17. 73±6. 23,19. 76±5. 43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level (t = 12. 643, 11. 837, 10. 324, 8. 839, 8. 462, 8. 046, all P 0. 05). At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient. CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.