Allogeneic corneal stromal flap applied in implantation of Ahmed glaucoma valve / 中华显微外科杂志

ABSTRACT

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.