ABSTRACT
BACKGROUND: To evaluate the effect of Ozurdex® on intraocular pressure in patients with macular edema alone (group 1) or associated with glaucoma or ocular hypertension (group 2). METHODS: A clinical, retrospective, observational, comparative study included 92 eyes with macular edema treated with a single injection of Ozurdex®; 27 eyes were previously diagnosed with glaucoma or ocular hypertension. RESULTS: The mean intraocular pressure (group 1 vs. group 2) after injection was 12.1 versus 19.9 mm Hg, (p < 0.05; day 1); 17.5 versus 19.7 mm Hg (p < 0.05; month 1); 18.4 versus 20.9 mm Hg (p < 0.05; month 2); 15 versus 17.4 mm Hg (p < 0.05; month 3); 13.9 versus 16.7 mm Hg (p > 0.05; month 6); 13.8 versus 15.1 mm Hg (p > 0.05; month 9) and 13.1 versus 16.4 mm Hg (p > 0.05; month 12). Thirty eyes (32.6%) showed ocular hypertension (intraocular pressure >21 mm Hg) after the injection: 21.5% of group 1 and 59.3% of group 2. In group 2, 27 eyes (100%) needed medical treatment to reduce intraocular pressure in comparison to 8 patients (12.3%) in group 1 (p < 0.001). CONCLUSIONS: Intravitreal injection of Ozurdex® was associated with ocular hypertension in 32.6% of the eyes. Previous glaucoma or ocular hypertension are risk factors for this increase.
Subject(s)
Dexamethasone/adverse effects , Glucocorticoids/adverse effects , Intraocular Pressure/drug effects , Macular Edema/drug therapy , Ocular Hypertension/chemically induced , Adult , Aged , Aged, 80 and over , Dexamethasone/administration & dosage , Drug Implants , Female , Glaucoma/complications , Glucocorticoids/administration & dosage , Humans , Intravitreal Injections , Male , Middle Aged , Retrospective Studies , Risk Factors , Tonometry, Ocular , Vitreous Body , Young AdultABSTRACT
PURPOSE: The aim of this study was to describe a new technique for the treatment of Ahmed valve plate exposure used in a patient with recurrent valvular plate exposure. BACKGROUND: An important complication of glaucoma drainage devices is its exposure. The treatment options reported include the use of different grafts covered by mucosa or conjunctiva. Despite these treatments many valves reexpose, especially in patients with previously damaged conjunctiva. METHODS: We report the case of a patient with Acanthamoeba keratitis and secondary angle closure glaucoma, who underwent a penetrating keratoplasty and an Ahmed valve implantation, and presented with repeated valvular plate exposure. After consecutive unsuccessful coverage methods, a novel use of a tarsoconjunctival flap was performed to solve this complication. CONCLUSIONS: Upper eyelid tarsoconjunctival flap is a useful option to cover exposed valvular plates in patients where traditional methods have failed.
