The Short Term Effect of Ocular Digital Massage and its Echographic Evaluation Following Ahmed Glaucoma Valve Implantation

ABSTRACT

We performed a prospective study to evaluate the effect of ocular digital massage (ODM) on intraocular pressure (IOP) in eyes that underwent implantation of Ahmed Glaucoma Valve (AGV) for refractory glaucoma. Echographic study(B scan) was also used to visualize the formation of bleb around the implant and change of its size following ODM. There were 14 eyes(13 patients) in which pre-massage IOP was 17.79 +/- 6.19 mmHg and the immediate post-massage lOP showed 11.00 +/- 6.11 mmHg . IOP in 6 hours after ODM was 15.43 +/- 7.32 mmHg . These reductions in lOP were statistically significant (paired t-test, p=0.005). When classified into two groups based on the type of glaucoma and IOP reduction after ODM was compared, there was no statistically significant difference between the group with neovascular glaucoma (NVG) and that with chronic angle closure glaucoma (t-test, p=0.328). The ultrasound study showed well formed bleb around the implant in those eyes with good IOP control. Increase in the size of bleb was shown even in those with marginal/poor IOP control following ODM. There was no significant complication associated with ODM except in one eye with persistent hypotony. In conclusion, ODM showed a significant IOP reduction in short term in eyes with AGV and its relationship with bleb size was well documented with the use of echograph.