Managing high risk glaucoma with the Ahmed valve implant: 20 years of experience

AIM: To estimate the efficacy and safety of the Ahmed implant in patients with high risk for failure after glaucoma surgery. METHODS: In 342 eyes of 342 patients with refractory glaucoma, even with application of medical treatment, the Ahmed valve was introduced for intraocular pressure (IOP) contr...

Full description

Bibliographic Details
Main Authors: Tryfon Rotsos, Anastasia Tsioga, Konstantinos Andreanos, Andreas Diagourtas, Petros Petrou, Ilias Georgalas, Dimitrios Papaconstantinou
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2018-02-01
Series:International Journal of Ophthalmology
Subjects:
244
Online Access:http://www.ijo.cn/en_publish/2018/2/20180210.pdf
id doaj-1f3a7c4a9865498582f91d0133e67f5e
record_format Article
spelling doaj-1f3a7c4a9865498582f91d0133e67f5e2020-11-24T23:55:20ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982018-02-0111224024410.18240/ijo.2018.02.10Managing high risk glaucoma with the Ahmed valve implant: 20 years of experienceTryfon Rotsos0Anastasia Tsioga1Konstantinos Andreanos2Andreas Diagourtas3Petros Petrou4Ilias Georgalas5Dimitrios Papaconstantinou6Department of Ophthalmology, University of Athens, General Hospital of Athens, Mesogion 154 Ave, Athens 11527, GreeceDepartment of Ophthalmology, University of Athens, General Hospital of Athens, Mesogion 154 Ave, Athens 11527, GreeceDepartment of Ophthalmology, University of Athens, General Hospital of Athens, Mesogion 154 Ave, Athens 11527, GreeceDepartment of Ophthalmology, University of Athens, General Hospital of Athens, Mesogion 154 Ave, Athens 11527, GreeceDepartment of Ophthalmology, University of Athens, General Hospital of Athens, Mesogion 154 Ave, Athens 11527, GreeceDepartment of Ophthalmology, University of Athens, General Hospital of Athens, Mesogion 154 Ave, Athens 11527, GreeceDepartment of Ophthalmology, University of Athens, General Hospital of Athens, Mesogion 154 Ave, Athens 11527, GreeceAIM: To estimate the efficacy and safety of the Ahmed implant in patients with high risk for failure after glaucoma surgery. METHODS: In 342 eyes of 342 patients with refractory glaucoma, even with application of medical treatment, the Ahmed valve was introduced for intraocular pressure (IOP) control, in the period of the last 20y. The nature of glaucoma was neovascular in 162 eyes, pseudophakic or aphakic in 49 eyes, inflammatory in 29 eyes and non working previous antiglaucomatic surgical interventions in 102 eyes. RESULTS: Follow-up ranged from 18 to 120mo with a mean follow-up of 63.2mo. IOP before the operation decreased from 31.6±10.4 mm Hg to 18.3±5.4 mm Hg (no systemic treatment) at the end of follow up period. When we compared the IOP values before the operation using ANOVA showed statistically significant difference (P<0.001). The success rate was 85.2% during the first semester, 76.8% at 12mo and 50.3% at the end of follow up period (18 to 120mo after implantation). Success rate was 25.7% in neovascular glaucoma, 63.2% in aphakic glaucoma and 73.8% in non working previous antiglaucomatic surgical interventions. Complications due to the implant were: serous choroidal detachment in 14.8%, blockage of the tube in 2.8%, malposition of the tube in 4.9%, suprachoroidal hemorrhage in 2.1%, cataract progression in 39.6% (phakic eyes), shallow anterior chamber in 9.2%, hyphaema in 28.9%, exposure of valve in 2.6%, exposure of tube in 9.3%, hypotony in 4.9% and conjunctival fibrosis in 41.5%. CONCLUSION: Despite the fact that Ahmed valve implant had suchlike results as other implants concerning the IOP control, complications rate due to hypotony or over filtration in the first days after the intervention are not that frequent as with other valve implants.http://www.ijo.cn/en_publish/2018/2/20180210.pdf244Ahmed valvehigh risk glaucomaneovascular glaucomaaphakic glaucomapseudophakic glaucomainflammatory glaucoma
collection DOAJ
language English
format Article
sources DOAJ
author Tryfon Rotsos
Anastasia Tsioga
Konstantinos Andreanos
Andreas Diagourtas
Petros Petrou
Ilias Georgalas
Dimitrios Papaconstantinou
spellingShingle Tryfon Rotsos
Anastasia Tsioga
Konstantinos Andreanos
Andreas Diagourtas
Petros Petrou
Ilias Georgalas
Dimitrios Papaconstantinou
Managing high risk glaucoma with the Ahmed valve implant: 20 years of experience
International Journal of Ophthalmology
244
Ahmed valve
high risk glaucoma
neovascular glaucoma
aphakic glaucoma
pseudophakic glaucoma
inflammatory glaucoma
author_facet Tryfon Rotsos
Anastasia Tsioga
Konstantinos Andreanos
Andreas Diagourtas
Petros Petrou
Ilias Georgalas
Dimitrios Papaconstantinou
author_sort Tryfon Rotsos
title Managing high risk glaucoma with the Ahmed valve implant: 20 years of experience
title_short Managing high risk glaucoma with the Ahmed valve implant: 20 years of experience
title_full Managing high risk glaucoma with the Ahmed valve implant: 20 years of experience
title_fullStr Managing high risk glaucoma with the Ahmed valve implant: 20 years of experience
title_full_unstemmed Managing high risk glaucoma with the Ahmed valve implant: 20 years of experience
title_sort managing high risk glaucoma with the ahmed valve implant: 20 years of experience
publisher Press of International Journal of Ophthalmology (IJO PRESS)
series International Journal of Ophthalmology
issn 2222-3959
2227-4898
publishDate 2018-02-01
description AIM: To estimate the efficacy and safety of the Ahmed implant in patients with high risk for failure after glaucoma surgery. METHODS: In 342 eyes of 342 patients with refractory glaucoma, even with application of medical treatment, the Ahmed valve was introduced for intraocular pressure (IOP) control, in the period of the last 20y. The nature of glaucoma was neovascular in 162 eyes, pseudophakic or aphakic in 49 eyes, inflammatory in 29 eyes and non working previous antiglaucomatic surgical interventions in 102 eyes. RESULTS: Follow-up ranged from 18 to 120mo with a mean follow-up of 63.2mo. IOP before the operation decreased from 31.6±10.4 mm Hg to 18.3±5.4 mm Hg (no systemic treatment) at the end of follow up period. When we compared the IOP values before the operation using ANOVA showed statistically significant difference (P<0.001). The success rate was 85.2% during the first semester, 76.8% at 12mo and 50.3% at the end of follow up period (18 to 120mo after implantation). Success rate was 25.7% in neovascular glaucoma, 63.2% in aphakic glaucoma and 73.8% in non working previous antiglaucomatic surgical interventions. Complications due to the implant were: serous choroidal detachment in 14.8%, blockage of the tube in 2.8%, malposition of the tube in 4.9%, suprachoroidal hemorrhage in 2.1%, cataract progression in 39.6% (phakic eyes), shallow anterior chamber in 9.2%, hyphaema in 28.9%, exposure of valve in 2.6%, exposure of tube in 9.3%, hypotony in 4.9% and conjunctival fibrosis in 41.5%. CONCLUSION: Despite the fact that Ahmed valve implant had suchlike results as other implants concerning the IOP control, complications rate due to hypotony or over filtration in the first days after the intervention are not that frequent as with other valve implants.
topic 244
Ahmed valve
high risk glaucoma
neovascular glaucoma
aphakic glaucoma
pseudophakic glaucoma
inflammatory glaucoma
url http://www.ijo.cn/en_publish/2018/2/20180210.pdf
work_keys_str_mv AT tryfonrotsos managinghighriskglaucomawiththeahmedvalveimplant20yearsofexperience
AT anastasiatsioga managinghighriskglaucomawiththeahmedvalveimplant20yearsofexperience
AT konstantinosandreanos managinghighriskglaucomawiththeahmedvalveimplant20yearsofexperience
AT andreasdiagourtas managinghighriskglaucomawiththeahmedvalveimplant20yearsofexperience
AT petrospetrou managinghighriskglaucomawiththeahmedvalveimplant20yearsofexperience
AT iliasgeorgalas managinghighriskglaucomawiththeahmedvalveimplant20yearsofexperience
AT dimitriospapaconstantinou managinghighriskglaucomawiththeahmedvalveimplant20yearsofexperience
_version_ 1725462988261949440