Journal of Current Glaucoma Practice

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VOLUME 10 , ISSUE 3 ( September-December, 2016 ) > List of Articles

Original Article

Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy

Rui B Schimiti, Ricardo Y Abe, Carla M Tavares, Jose PC Vasconcellos, Vital P Costa

Keywords : Ahmed glaucoma valve, Glaucoma surgery, Intraocular pressure, Retrospective study

Citation Information : B Schimiti R, Y Abe R, M Tavares C, PC Vasconcellos J, P Costa V. Intraocular Pressure Control after Implantation of an Ahmed Glaucoma Valve in Eyes with a Failed Trabeculectomy. J Curr Glaucoma Pract 2016; 10 (3):97-103.

DOI: 10.5005/jp-journals-10008-1209

License: CC BY-NC 4.0

Published Online: 01-12-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To evaluate the results of Ahmed glaucoma valve (AGV) in eyes with a failed trabeculectomy. Materials and methods: This retrospective study evaluated 61 eyes with a failed trabeculectomy that underwent implantation of an AGV due to uncontrolled intraocular pressure (IOP) on maximal medical therapy. Success was defined as IOP < 21 mm Hg (criterion 1) or 20% reduction in IOP (criterion 2) with or without antiglaucoma medications. Persistent hypotony, loss of light perception, and reoperation for IOP control were defined as failure. Results: Mean preoperative IOP and mean lOPs at 6, 12, and 24 months were 21.93 ± 6.32 mm Hg (n = 61), 14.15 ± 4.33 mm Hg (n = 59), 13.21 ± 4.44 mm Hg (n = 56), and 13.60 ± 3.27 mm Hg (n = 25) respectively. Mean number of antiglaucoma medications preoperatively and at 6, 12, and 24 months was 3.95 ± 0.85, 2.19 ± 1.38, 2.48 ± 1.44, and 2.40 ± 1.32 respectively. The reductions in the number of medications and IOP measurements were statistically significant at all time intervals (p < 0.001, Wilcoxon signed rank test). According to criterion 1, the Kaplan-Meier survival curve disclosed success rates of 75% at 12 and 24 months. According to criterion 2, the success rates were 57% at 12 months and 55% at 24 months. The most frequent complications were hypertensive phase (18%) and shallow anterior chamber (16.4%). Conclusion: The AGV may effectively reduce IOP in eyes that had a failed trabeculectomy. Clinical significance: The AGV is an alternative in eyes with a failed trabeculectomy.


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  1. Stein JD, Ruiz D Jr, Belsky D, Lee PP, Sloan FA. Longitudinal rates of postoperative adverse outcomes after glaucoma surgery among Medicare beneficiaries 1994 to 2005. Ophthalmology 2008 Jul;115(7):1109-1116.e7.
  2. Ramulu PY, Corcoran KJ, Corcoran SL, Robin AL. Utilization of various glaucoma surgeries and procedures in Medicare beneficiaries from 1995 to 2004. Ophthalmology 2007 Dec;114(12): 2265-2270.
  3. Lim KS, Allan BD, Lloyd AW, Muir A, Khaw PT. Glaucoma drainage devices; past, present, and future. Br J Ophthalmol 1998 Sep;82(9):1083-1089.
  4. Barton K, Feuer WJ, Budenz DL, Schiffman J, Costa VP, Godfrey DG, Buys YM, Ahmed Baerveldt Comparison Study Group. Three-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology 2014 Aug;121(8):1547-1557.e1.
  5. Budenz DL, Barton K, Gedde SJ, Feuer WJ, Schiffman J, Costa VP, Godfrey DG, Buys YM, Ahmed Baerveldt Comparison Study Group. Five-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology 2015 Feb;122(2):308-316.
  6. Christakis PG, Tsai JC, Kalenak JW, Zurakowski D, Cantor LB, Kammer JA, Ahmed II. The Ahmed versus Baerveldt study: three-year treatment outcomes. Ophthalmology 2013 Nov;120(11):2232-2240.
  7. Arcieri ES, Paula JS, Jorge R, Barella KA, Arcieri RS, Secches DJ, Costa VP. Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing Ahmed glaucoma valve implantation: 2-year follow-up. Acta Ophthalmol 2015 Feb;93(1):e1-e6.
  8. Ayyala RS, Zurakowski D, Smith JA, Monshizadeh R, Netland PA, Richards DW, Layden WE. A clinical study of the Ahmed glaucoma valve implant in advanced glaucoma. Ophthalmology 1998 Oct;105(10):1968-1976.
  9. Chen A, Yu F, Law SK, Giaconi JA, Coleman AL, Caprioli J. Valved glaucoma drainage devices in pediatric glaucoma: retrospective long-term outcomes. JAMA Ophthalmol 2015 Sep;133(9):1030-1035.
  10. Chen TC, Bhatia LS, Walton DS. Ahmed valve surgery for refractory pediatric glaucoma: a report of 52 eyes. J Pediatr Ophthalmol Strabismus 2005 Sep-Oct;42(5):274-283; quiz 304-305.
  11. Im YW, Lym HS, Park CK, Moon JI. Comparison of mitomycin C trabeculectomy and Ahmed valve implant surgery for neovascular glaucoma. J Korean Ophthalmol Soc 2004;45(9): 1515-1521.
  12. Lai JS, Poon AS, Chua JK, Tham CC, Leung AT, Lam DS. Efficacy and safety of the Ahmed glaucoma valve implant in Chinese eyes with complicated glaucoma. Br J Ophthalmol 2000 Jul;84(7):718-721.
  13. Panda A, Prakash VJ, Dada T, Gupta AK, Khokhar S, Vanathi M. Ahmed glaucoma valve in post-penetrating-keratoplasty glaucoma: a critically evaluated prospective clinical study. Indian J Ophthalmol 2011 May-Jun;59(3):185-189.
  14. Papadaki TG, Zacharopoulos IP, Pasquale LR, Christen WB, Netland PA, Foster CS. Long-term results of Ahmed glaucoma valve implantation for uveitic glaucoma. Am J Ophthalmol 2007 Jul;144(1):62-69.
  15. Shah MR, Khandekar RB, Zutshi R, Mahrooqi R. Short term outcome of Ahmed glaucoma valve implantation in management of refractory glaucoma in a tertiary hospital in Oman. Oman J Ophthalmol 2013 Jan;6(1):27-32.
  16. Zhang HT, Yang YX, Xu YY, Yang RM, Wang BJ, Hu JX. Intravitreal bevacizumab and Ahmed glaucoma valve implantation in patients with neovascular glaucoma. Int J Ophthalmol 2014 Oct 18;7(5):837-842.
  17. Spaeth GL. Ophthalmic surgery: principles and practice. 2nd ed. Philadelphia (PA): WB Saunders; 1990.
  18. Chen PP, Yamamoto T, Sawada A, Parrish RK 2nd, Kitazawa Y. Use of antifibrosis agents and glaucoma drainage devices in the American and Japanese Glaucoma Societies. J Glaucoma 1997 Jun;6(3):192-196.
  19. Desai MA, Gedde SJ, Feuer WJ, Shi W, Chen PP, Parrish RK 2nd. Practice preferences for glaucoma surgery: a survey of the American glaucoma society in 2008. Ophthalmic Surg Lasers Imaging 2011 May 1;42(3).
  20. Joshi AB, Parrish RK 2nd, Feuer WF. 2002 survey of the American Glaucoma Society: practice preferences for glaucoma surgery and antifibrotic use. J Glaucoma 2005 Apr;14(2): 172-174.
  21. Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC. Surgical complications in the Tube Versus Trabeculectomy Study during the first year of follow-up. Am J Ophthalmol 2007 Jan;143(1):23-31.
  22. Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL. Treatment outcomes in the tube versus trabeculectomy study after one year of follow-up. Am J Ophthalmol 2007 Jan;143(1):9-22.
  23. HaiBo T, Xin K, ShiHeng L, Lin L. Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis. PloS One 2015 Feb 26;10(2):e0118142.
  24. Nouri-Mahdavi K, Caprioli J. Evaluation of the hypertensive phase after insertion of the Ahmed Glaucoma Valve. Am J Ophthalmol 2003 Dec;136(6):1001-1008.
  25. Tran DH, Souza C, Ang MJ, Loman J, Law SK, Coleman AL, Caprioli J. Comparison of long-term surgical success of Ahmed Valve implant versus trabeculectomy in open-angle glaucoma. Br J Ophthalmol 2009 Nov;93(11):1504-1509.
  26. Tsai JC, Johnson CC, Kammer JA, Dietrich MS. The Ahmed shunt versus the Baerveldt shunt for refractory glaucoma II: longer-term outcomes from a single surgeon. Ophthalmology 2006 Jun;113(6):913-917.
  27. Wilson MR, Mendis U, Paliwal A, Haynatzka V. Long-term follow-up of primary glaucoma surgery with Ahmed glaucoma valve implant versus trabeculectomy. Am J Ophthalmol 2003 Sep;136(3):464-470.
  28. Lee TY, Lee JH, Cha SC. Trabeculectomy with mitomycin C versus Ahmed valve implantation in pseudophakic glaucomatous eyes. J Korean Ophthalmol Soc 2008;49(2):293-302.
  29. Pakravan M, Homayoon N, Shahin Y, Ali Reza BR. Trabeculectomy with mitomycin C versus Ahmed glaucoma implant with mitomycin C for treatment of pediatric aphakic glaucoma. J Glaucoma 2007 Oct-Nov;16(7):631-636.
  30. Shen CC, Salim S, Du H, Netland PA. Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma. Clin Ophthalmol 2011;5:281-286.
  31. Budenz DL, Barton K, Feuer WJ, Schiffman J, Costa VP, Godfrey DG, Buys YM, Ahmed Baerveldt Comparison Study Group. Treatment outcomes in the Ahmed Baerveldt Comparison Study after 1 year of follow-up. Ophthalmology 2011 Mar;118(3):443-452.
  32. Ishida K, Netland PA, Costa VP, Shiroma L, Khan B, Ahmed II. Comparison of polypropylene and silicone Ahmed Glaucoma Valves. Ophthalmology 2006 Aug;113(8):1320-1326.
  33. Devgan U, Yu F, Kim E, Coleman AL. Surgical undertreatment of glaucoma in black beneficiaries of Medicare. Arch Ophthalmol 2000 Feb;118(2):253-256.
  34. Ederer F, Gaasterland DA, Dally LG, Kim J, Van Veldhuisen PC, Blackwell B, Prum B, Shafranov G, Allen RC, Beck A, et al. The Advanced Glaucoma Intervention Study (AGIS): 13. Comparison of treatment outcomes within race: 10-year results. Ophthalmology 2004 Apr;111(4):651-664.
  35. Mermoud A, Salmon JF, Murray AD. Trabeculectomy with mitomycin C for refractory glaucoma in blacks. Am J Ophthalmol 1993 Jul 15;116(1):72-78.
  36. Morris DA, Peracha MO, Shin DH, Kim C, Cha SC, Kim YY. Risk factors for early filtration failure requiring suture release after primary glaucoma triple procedure with adjunctive mitomycin. Arch Ophthalmol 1999 Sep;117(9): 1149-1154.
  37. Ishida K, Netland PA. Ahmed Glaucoma Valve implantation in African American and white patients. Arch Ophthalmol 2006 Jun;124(6):800-806.
  38. Abe RY, Tavares CM, Schimiti RB, Vasconcellos JP, Costa VP. Ahmed glaucoma valve implantation for refractory glaucoma in a tertiary hospital in Brazil. J Ophthalmol 2015;2015:850785.
  39. Eibschitz-Tsimhoni M, Schertzer RM, Musch DC, Moroi SE. Incidence and management of encapsulated cysts following Ahmed glaucoma valve insertion. J Glaucoma 2005 Aug;14(4):276-279.
  40. Law SK, Kornmann HL, Giaconi JA, Kwong A, Tran E, Caprioli J. Early aqueous suppressant therapy on hypertensive phase following glaucoma drainage device procedure: a randomized prospective trial. J Glaucoma 2016 Mar;25(3):248-257.
  41. Pakravan M, Rad SS, Yazdani S, Ghahari E, Yaseri M. Effect of early treatment with aqueous suppressants on Ahmed glaucoma valve implantation outcomes. Ophthalmology 2014 Sep;121(9):1693-1698.
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