PURPOSE: To investigate surgical outcomes after pars plana implantation of the Ahmed glaucoma valve (ppAGV). METHODS: The intraocular pressure, corneal endothelial damage and post-surgical complications of 31 consecutive refractory glaucoma eyes of 26 subjects who underwent ppAGV were prospectively studied at two centers. RESULTS: Cell density (CD) at the central cornea decreased by 3.5 ± 15.0 and 10.2 ± 18.9% at 6 and 12 months, respectively. The CD loss at 1 year was comparable with the loss after cataract surgery alone (6.5 ± 8.5%, P = 0.441). Hexagonality (Hex) changed little, from 41.5 ± 15.6% at baseline to 41.8 ± 14.9% (P = 0.976) at 6 months and 41.6 ± 10.2% (P = 0.58) at 12 months. The coefficient of variation of the central corneal endothelium area (CV) changed from 40.7 ± 9.0% at baseline to 45.7 ± 12.6% (P = 0.078) at 6 months and 45.5 ± 11.2% (P = 0.013) at 12 months. Concomitant cataract surgery was a significant risk factor for CD loss. The probabilities of success or qualified success at 1 year were 66.1 and 83.6%, respectively. Most of the posterior segment complications, which were noted in 6 of 31 eyes (19%), were self-limiting, except for 2 eyes (6%) that developed retinal detachment as a consequence of kissing choroidal detachment. CONCLUSIONS: Corneal endothelial damage was minimal, and the success probability was relatively high after ppAGV in refractive glaucoma cases.
PURPOSE: To investigate surgical outcomes after pars plana implantation of the Ahmed glaucoma valve (ppAGV). METHODS: The intraocular pressure, corneal endothelial damage and post-surgical complications of 31 consecutive refractory glaucoma eyes of 26 subjects who underwent ppAGV were prospectively studied at two centers. RESULTS: Cell density (CD) at the central cornea decreased by 3.5 ± 15.0 and 10.2 ± 18.9% at 6 and 12 months, respectively. The CD loss at 1 year was comparable with the loss after cataract surgery alone (6.5 ± 8.5%, P = 0.441). Hexagonality (Hex) changed little, from 41.5 ± 15.6% at baseline to 41.8 ± 14.9% (P = 0.976) at 6 months and 41.6 ± 10.2% (P = 0.58) at 12 months. The coefficient of variation of the central corneal endothelium area (CV) changed from 40.7 ± 9.0% at baseline to 45.7 ± 12.6% (P = 0.078) at 6 months and 45.5 ± 11.2% (P = 0.013) at 12 months. Concomitant cataract surgery was a significant risk factor for CD loss. The probabilities of success or qualified success at 1 year were 66.1 and 83.6%, respectively. Most of the posterior segment complications, which were noted in 6 of 31 eyes (19%), were self-limiting, except for 2 eyes (6%) that developed retinal detachment as a consequence of kissing choroidal detachment. CONCLUSIONS:Corneal endothelial damage was minimal, and the success probability was relatively high after ppAGV in refractive glaucoma cases.
Authors: David C Ritterband; Daniel Shapiro; Valeriya Trubnik; Michael Marmor; Seth Meskin; John Seedor; Jeffrey M Liebmann; Celso Tello; Richard Koplin; Noga Harizman; Uri Shabto; Robert Ritch Journal: Cornea Date: 2007-10 Impact factor: 2.651