ABSTRACT
PURPOSE: To evaluate the outcome of combined Ahmed glaucoma valve (AGV) and phacoemulsification with posterior chamber intraocular lens implantation under infliximab in refractory uveitic glaucoma (UG). METHODS: In this prospective interventional case series, 26 eyes of 26 patients with refractory UG underwent surgery under intravenous infliximab. The success rate was defined as intraocular pressure (IOP) 5 to 21 mm Hg with or without antiglaucoma medications (AGM), without additional glaucoma surgical intervention. RESULTS: The mean IOP (37.8 ± 11.86 to 12.2 ± 2.8 mm Hg; p<0.0001) and mean number of AGM (3.4 ± 1.2 to 0.4 ± 0.1; p<0.001) were significantly reduced after surgery at 2 years. Kaplan-Meier survival analysis showed a cumulative probability of success for IOP control of 92% at 2 years of follow-up. CONCLUSIONS: Combined AGV and phacoemulsification is an effective treatment for controlling refractory UG with complicated cataract under infliximab.
Subject(s)
Antirheumatic Agents/administration & dosage , Glaucoma Drainage Implants , Glaucoma/surgery , Infliximab/administration & dosage , Lens Implantation, Intraocular , Phacoemulsification/methods , Uveitis, Anterior/surgery , Adult , Female , Glaucoma/etiology , Humans , Infusions, Intravenous , Intraocular Pressure/physiology , Male , Middle Aged , Prospective Studies , Prosthesis Implantation , Tonometry, Ocular , Treatment Outcome , Uveitis, Anterior/complications , Visual Acuity/physiologyABSTRACT
AIM: To evaluate the efficacy of Ahmed glaucoma valve (AGV) drainage devices in cases of adult refractory glaucoma in Indian eyes. SETTINGS AND DESIGN: Retrospective interventional case series study. MATERIALS AND METHODS: Fifty two eyes of 32 patients of refractory glaucoma in the age group of 35 to 60 years who underwent AGV implantation with or without concomitant procedures from January 2003 to Jan 2007 were studied. Of these, 46 eyes (88%) had undergone filtering surgery earlier whereas remaining eyes underwent primary AGV implantation following failure of maximal medical therapy. The follow up ranged between 12 months to 48 months RESULTS: Eighteen eyes (35%) had undergone phacoemulsification with AGV implantation, penetrating keratoplasty (PK) with AGV and intraocular lens (IOL) implantation in 13 eyes (25%), AGV over preexisting IOL in eight eyes (15%). AGV implantation alone was done in six (11%) eyes. Anterior chamber (AC) reconstruction with secondary IOL and AGV was performed in the remaining eyes. The mean intra ocular pressure (IOP) decreased from 36.3 +/- 15.7 mm Hg to 19.6 +/- 9.2 mm Hg. Complete success as per criteria was achieved in 46 eyes (88%). None of the eyes had failure to maintain IOP control following AGV. CONCLUSION: The AGV resulted in effective and sustained control of IOP in cases of adult refractory glaucoma in intermediate follow up.
