ABSTRACT
Purpose: This study aimed to compare the success and complication rates among patients implanted with Ahmed Glaucoma Valve (AGV) using the short and long tunnel technique through retrospective chart review. Patients and Methods: We reviewed 54 charts of adult patients who underwent AGV implantation using a Short-Needle Track (SNT) or Long-Needle Track (LNT) technique. Intraocular pressures (IOP), Best Corrected Visual Acuity (BCVA) and number of medications were recorded pre-operatively, and at Day 1, 3, 7, Month 1, 3, 6 post-operatively. Treatment success, occurrence of Hypertensive Phase (HP), complication and procedures done after AGV implantation were compared between the two groups using one-tailed Z-test of proportions. Results: A total of 20 (LNT) and 21 (SNT) charts were included in the study. There was no significant difference between the median postoperative IOP, BCVA, and number of anti-glaucoma medications between the two groups at each time interval. The comparison between the occurrence of HP (P = 0.435) and success rates (P = 0.476) between the two groups yielded no significant difference. Flat/shallow anterior chamber (AC) was seen exclusively in three eyes (14%) in the SNT group (P = 0.039). There was one occurrence of plate exposure in the LNT group (P = 0.149). Conclusion: The LNT technique of AGV Implantation may be used as an alternative to the traditional SNT (with autologous graft). The long needle track offers the advantage reducing the risk of complications arising from shallow anterior chamber post-operatively.
ABSTRACT
PURPOSE: The purpose of this study was to report a rare case of late-onset subconjunctival abscess associated with an unexposed Ahmed glaucoma valve implant secondary to Serratia marcescens, a rare conjunctival pathogen. METHODS: Case description including clinical imaging and literature review of glaucoma drainage device (GDD)-related infections. CASE PRESENTATION: A 73-year-old man presented with blurring of vision, redness, and pain on his right eye 2 months after Ahmed glaucoma valve implantation for advanced postpenetrating-keratoplasty glaucoma. The patient was nonsmoker, had fairly controlled type 2 diabetes mellitus on insulin, and had undergone multiple eye surgeries on the right eye. On ocular examination, the conjunctiva was injected with fairly delineated yellowish-white subconjunctival material in the superotemporal quadrant with no associated tube exposure or leak, and the anterior chamber was quiet. The patient was assessed with Ahmed glaucoma valve infection with subconjunctival abscess and was treated by Ahmed glaucoma valve explant with directed systemic and topical antimicrobial therapy. The culture and sensitivity results revealed S. marcescens sensitive to ciprofloxacin, ceftazidime, gentamicin, and amikacin. Despite the virulence of the pathogen, the eye was saved. CONCLUSIONS: Ahmed glaucoma valve infection with subconjunctival abscess secondary to S. marcescens is rare. GDD-related infections should be suspected in patients presenting with blurring of vision, pain, and redness even in the absence of tube exposure. Early diagnosis and treatment with culture-guided antimicrobial therapy combined with GDD explant is fundamental in optimizing the visual outcome.
Subject(s)
Abscess/etiology , Conjunctiva/microbiology , Eye Infections, Bacterial/etiology , Glaucoma Drainage Implants/adverse effects , Glaucoma/surgery , Prosthesis-Related Infections/diagnosis , Serratia Infections/etiology , Serratia marcescens/isolation & purification , Abscess/diagnosis , Abscess/microbiology , Aged , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/microbiology , Humans , Male , Prosthesis-Related Infections/microbiology , Serratia Infections/diagnosis , Serratia Infections/microbiologyABSTRACT
An interventional case report is described of a patient with chronic postoperative endophthalmitis caused by the gram-negative aerobic rod Pseudomonas luteola. A 61-year-old developed slowly progressive blurring of vision, hypopyon, and vitritis following cataract surgery. Diagnostic vitrectomy and intraocular lens explantation were performed. The undiluted vitreous samples and explanted lens were analyzed. Aerobic cultures revealed moderate growth of P. luteola. The patient responded to intravitreal injections of piperacillin/tazobactam and oral trimethoprim/sulfamethoxasole. Best-corrected visual acuity improved from hand motions to 20/40. A repeat anterior chamber tap was negative. P. luteola may be a relatively nonvirulent cause of chronic endophthalmitis. Good visual outcomes may be obtained with appropriate therapy.
Subject(s)
Endophthalmitis/microbiology , Eye Infections, Bacterial/microbiology , Pseudomonas Infections/microbiology , Pseudomonas/isolation & purification , Vitreous Body/microbiology , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Drug Administration Routes , Endophthalmitis/diagnosis , Endophthalmitis/therapy , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/therapy , Female , Follow-Up Studies , Humans , Middle Aged , Pseudomonas Infections/pathology , Pseudomonas Infections/therapy , Visual Acuity , VitrectomyABSTRACT
PURPOSE: To report the efficacy of primary retrobulbar chlorpromazine injections for the management of blind and seeing painful eyes. PATIENTS AND METHODS: Retrospective case series from three university hospitals was done. Twenty eyes of 20 patients with at least 3 months of follow-up are reported. Ten of these 20 eyes did not receive any other ophthalmic medications either 2 weeks before chlorpromazine injection or at any time point after injection. Treatment was considered successful if pain control lasted for at least 3 months, without the need for reinjection or enucleation. RESULTS: Sixteen of 20 (80.0%) eyes achieved successful pain control. There were no permanent complications in any patient. CONCLUSIONS: Retrobulbar chlorpromazine appears to be safe and effective for the management of pain in blind eyes.
