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Factors Associated with Outcomes of Combined Phacoemulsification and Ahmed Glaucoma Valve Implantation
Korean Journal of Ophthalmology ; : 211-220, 2018.
Article Dans Anglais | WPRIM | ID: wpr-714959
ABSTRACT

PURPOSE:

To evaluate outcomes and factors associated with surgical failure in patients who underwent combined phacoemulsification and Ahmed glaucoma valve (AGV) implantation.

METHODS:

This retrospective and longitudinal study enrolled 40 eyes (38 patients) that underwent combined phacoemulsification and AGV implantation. Visual acuity, intraocular pressure (IOP), and number of antiglaucoma medications were evaluated preoperatively and postoperatively. Complete success was defined as a last follow-up IOP of 6 to 21 mmHg without medication, qualified success as an IOP of 6 to 21 mmHg with medication, and failure as an IOP of >21 or <6 mmHg.

RESULTS:

The mean follow-up period was 18 ± 10 months. Preoperative diagnoses were chronic angle closure glaucoma (35.0%), neovascular glaucoma (22.5%), uveitic glaucoma (17.5%), primary open-angle glaucoma (15.0%), and other (10.0%). IOP decreased from a mean of 30.5 ± 8.7 to 14.5 ± 3.7 mmHg at the last follow-up visit (p < 0.001). Treatment was classified as qualified success in 18 eyes (45%), complete success in 15 (37.5%), and failure in seven (17.5%). Twenty-two eyes (55%) showed improvement in visual acuity. The most common postoperative complication was a transient hypertensive phase (five eyes, 12.5%). Tube-iris touch was associated with surgical failure (hazard ratio, 8.615; p = 0.008).

CONCLUSIONS:

Combined phacoemulsification and AGV implantation is an effective and safe surgical option for patients with refractory glaucoma and cataract. Postoperative tube-iris touch is an indicator of poor prognosis.
Sujets)

Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Complications postopératoires / Pronostic / Cataracte / Acuité visuelle / Glaucome à angle fermé / Glaucome / Glaucome à angle ouvert / Glaucome néovasculaire / Études rétrospectives / Études de suivi Type d'étude: Etude diagnostique / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Humains langue: Anglais Texte intégral: Korean Journal of Ophthalmology Année: 2018 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Complications postopératoires / Pronostic / Cataracte / Acuité visuelle / Glaucome à angle fermé / Glaucome / Glaucome à angle ouvert / Glaucome néovasculaire / Études rétrospectives / Études de suivi Type d'étude: Etude diagnostique / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Humains langue: Anglais Texte intégral: Korean Journal of Ophthalmology Année: 2018 Type: Article