Ahmed Valve Implantation in Post-Penetrating Keratoplasty Glaucoma : Four - Years Follow up

2016 ◽  
Vol 22 ◽  
pp. 41-46 ◽  
Author(s):  
Hazem Helmy ◽  
Omar Hashem ◽  
Sameh Abouelkhir
Keyword(s):  
Penetrating Keratoplasty ◽  
Ahmed Valve ◽  
Valve Implantation

scholarly journals Ahmed valve implantation results in children with uveitic glaucoma

2021 ◽  
Vol 14 (1) ◽  
pp. 30-34
Author(s):  
L. A. Katargina ◽  
E. V. Denisova ◽  
I. N. A. Bahaaeddin ◽  
M. A. Khrabrova
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Anterior Chamber Angle ◽  
Safe Method ◽  
Ahmed Valve ◽  
Valve Implantation ◽  
Chamber Angle

The purpose is to evaluate the effectiveness and safety of Ahmed valve implantation in children with refractory postuveitic glaucoma (PUG).Material and methods. Ahmed valve was implanted to 10 children aged 7 to 17 years (10 eyes) with open-angle or mixed PUG uncompensated even by a maximum antihypertensive mode. Previously, all patients had undergone an average of 2.1 ± 0.9 surgeries aimed at normalizing the intraocular pressure (IOP) (predominantly, sinus trabeculectomy). 6 eyes were pseudophakic, 2 phakic, 2 aphakic. Ahmed valves were implanted according to the generally accepted technique. At the time of surgery IOP was 30.50 ± 4.35 mm Hg on average. The follow-up postsurgical period ranged from 3.9 to 23.6 months (averagely, 14.1 ± 6.5).Results. A stable hypotensive effect of the intervention was achieved in 90 % of cases, of which 3 patients had no hypotensives while 6 patients received hypotensive drugs even though their quantity was significantly smaller than before surgery (1.7 ± 1.49, p=0.028). At the end of the follow-up the average IOP was 18.1 ± 5.34 mm Hg, (significantly lower than before surgery, p = 0.008). During surgery, 1 patient experienced bleeding from the vessels of the anterior chamber angle after paracentesis, which was stopped by tamponade with sterile air. In other cases, the surgery as well as the immediate and distant postoperative period showed no complications.Conclusion. Ahmed valve implantation is an effective and safe method of the surgical treatment of refractory PUG in children and can be recommended in cases when previous antiglaucomatous operations proved ineffective, including patients with pseudophakia and aphakia.

scholarly journals Transscleral Fixation of Black Diaphragm Intraocular Lens in Complete Aniridia and Aphakia Due to Posttraumatic Eye Rupture: A Pilot Study

2019 ◽  
Vol 8 (1) ◽  
pp. 46
Author(s):  
Tomasz Chorągiewicz ◽  
Katarzyna Nowomiejska ◽  
Dariusz Haszcz ◽  
Dominika Nowakowska ◽  
Teresio Avitabile ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Anterior Segment ◽  
Case Series ◽  
Functional Restoration ◽  
Long Term Outcomes ◽  
Ahmed Valve ◽  
Post Traumatic ◽  
Valve Implantation

Introduction: To assess long-term outcomes of implantation of black diaphragm intraocular lens (BD IOL) in post-traumatic aniridia and aphakia due to eye rupture. Methods: This is a retrospective consecutive case series of 14 eyes with post-traumatic complete aniridia and aphakia treated with scleral fixation BD IOL. Measurements included ophthalmological comorbidities, best corrected visual acuity (BCVA), complications, and postoperative interventions. The average postoperative follow-up period was 36 months. Results: BCVA improved in 6 cases, was stable in 6 cases and worsened in 2 cases. The lens was well centered in 13 cases. Glaucoma was diagnosed in six cases developed, and three of them required Ahmed valve implantation. One lens developed opacity. The cornea was decompensated in 6 cases, while two of them required penetrating keratoplasty. Conclusion: Implantation of BD IOL in eyes with severely traumatized eyes enables reconstruction of the anterior segment and some functional restoration, although many complications may arise during the longitudinal follow-up.

Single long scleral tunnel technique for prevention of Ahmed valve tube exposure

2018 ◽  
Vol 29 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Yadollah Eslami ◽  
Ebrahim Azaripour ◽  
Masoud Mohammadi ◽  
Mohammad Yaser Kiarudi ◽  
Ghasem Fakhraie ◽  
...  
Keyword(s):  
Case Series ◽  
Retrospective Case ◽  
Additional Material ◽  
Long Period ◽  
Scleral Tunnel ◽  
Ahmed Valve ◽  
Tunnel Technique ◽  
The Mean ◽  
Valve Implantation

Purpose: To evaluate the outcome of single long scleral tunnel technique for the prevention of conjunctival erosions caused by the Ahmed glaucoma valve. Methods: This study was a retrospective case series that included 30 eyes of 30 patients who underwent glaucoma valve implantation surgery by the single long scleral tunnel technique. Results: The mean age of patients at the time of surgery was 52 ± 21.6 years (range: 10–90 years). The mean visual acuity was 1.5 ± 0.81 logMAR preoperatively. The intraocular pressure was 40.7 ± 9.18 mm Hg (range: 25–58) before surgery that decreased significantly to 19.7 ± 3.1 mm Hg (range: 14–25; p < 0.0001) after a mean follow-up of 37.2 ± 5.9 months. During follow-up, no case of tube exposure was detected in patients. Conclusion: Single long scleral technique was efficacious with no occurrence of tube exposure in relatively long period of follow-up. In this method, there is no need to harvest any additional material, and in situations with limited access to patch grafts, it is performable with the minimal facilities.

Implantation of XEN After Failed Trabeculectomy: an Efficient Therapy?

2021 ◽  
Author(s):  
Caroline Bormann ◽  
Manuela Schmidt ◽  
Catharina Busch ◽  
Matus Rehak ◽  
Christian Thomas Scharenberg ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Standard Procedure ◽  
Field Tests ◽  
Glaucoma Surgery ◽  
Corrected Visual Acuity ◽  
Ahmed Valve ◽  
Long Time ◽  
The Mean ◽  
Valve Implantation

Abstract Background Trabeculectomy (TE) has been the standard procedure in glaucoma surgery for a long time. This study examined the efficacy and safety profile of XEN45 Gel Stent (XEN) after failed and/or scarred trabeculectomy. Material and Methods We analysed all files of patients, who received a XEN after insufficient TE and examined changes in intraocular pressure (IOP), IOP-lowering medication, best corrected visual acuity, visual field tests as well as the intra- and postoperative complications recorded within a 12-month follow-up period. Results 31 eyes of 28 patients were analysed in our study (mean age: 66,2 ± 13,4 years; 39% female; 48% right eye; mean follow-up after TE: 70,3 ± 64,9 months). The mean IOP decreased from 23,5 ± 6,5 to 18,0 ± 5,3 mmHg (− 23,5% compared to baseline-IOP; p = 0,01) while the mean IOP-lowering medication could be reduced from 2,8 ± 1,1 to 1,1 ± 1,5 (p < 0,01) 12 months after XEN-implantation. The mean visual acuity did not change significantly (pre-op: 0,5 ± 0,6 logMAR; 12 months post-op: 0,5 ± 0,6 logMAR). The most common complications postoperatively were choroideal detachment due to postoperative hypotony in 4 eyes (13%), a needling procedure in 9 eyes (29%), a Re-XEN-Implantation in 4 eyes (13%), an open revision of the conjunctiva in 3 eyes (10%), and a Re-TE in 1 eye (3%) as well as an Ahmed-Valve implantation in 2 eyes (6%). Overall, neither needling procedure nor further glaucoma surgery was necessary in 19 eyes (61%). In 10 of 22 evaluable eyes (45%) an IOP reduction of > 20% was achieved 12 months after XEN implantation. Conclusion XEN could be an effective method to reduce IOP after failed TE. The rate of complications seems to be low and the rate of needling procedures and/or revisions is acceptable.

scholarly journals Intravitreal Ranibizumab Injection as an Adjuvant in the Treatment of Neovascular Glaucoma Accompanied by Vitreous Hemorrhage after Diabetic Vitrectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Xi Shen ◽  
Yanwei Chen ◽  
Yanuo Wang ◽  
Lu Yang ◽  
Yisheng Zhong
Keyword(s):  
Adjuvant Therapy ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Vitreous Surgery ◽  
Intravitreal Ranibizumab ◽  
Additional Surgery ◽  
Ahmed Valve ◽  
Valve Implantation

Purpose.To determine the efficacy of intravitreal ranibizumab injection as adjuvant therapy in the treatment of neovascular glaucoma (NVG) accompanied by postvitrectomy diabetic vitreous hemorrhage (PDVH).Methods.Eighteen NVG patients (18 eyes) accompanied by PDVH were enrolled in this prospective, monocenter, 12-month, interventional case series. The consecutive 18 patients with an IOP ≥ 25 mmHg despite being treated with the maximum medical therapy were treated with intravitreal ranibizumab injections. Vitreous surgery or/with Ahmed valve implantation were indicated if no clinical improvement in vitreous haemorrhage and uncontrolled IOP was shown.Results.Ten patients got clear vitreous and controlled IOP only with2.7±1.8injections of ranibizumab without additional surgery. Vitrectomy or/with Ahmed valve implantation was administered in the other 8 eyes due to uncontrolled VH and IOP. At follow-up month 12, all the 18 eyes gained clear vitreous. At month 12 BCVA improved significantly compared to baseline. The baseline and follow-up at month 12 IOP/medication usage were36.7±8.1 mmHg on3.4±0.7medications and16.2±4.9 mmHg on0.67±0.77medications, respectively.Conclusions.The findings suggest that intravitreal ranibizumab injection as adjuvant therapy for treatment of NVG accompanied by PDVH may be safe and potentially effective. This clinical trial is registered withNCT02647515.

Ahmed valve implantation efficiency in children with refractory uveitic glaucoma

2020 ◽  
pp. 144-145
Author(s):  
M.A. Khrabrova ◽  
◽  
L.A. Katargina ◽  
E.V. Denisova ◽  
N.A. Ibaidbahaaeddin ◽  
...  
Keyword(s):  
Uveitic Glaucoma ◽  
Ahmed Valve ◽  
Valve Implantation

Актуальность. Постувеальная глаукома (ПУГ) представляет собой одну из самых тяжелых глауком детского возраста. Имплантации дренажей при ПУГ у детей посвящены лишь единичные работы, а полученные результаты неоднозначны, что требует дальнейшего изучения данного вопроса. Цель. Оценить эффективность имплантации клапана Ахмеда у детей с рефрактерной постувеальной глаукомой (ПУГ). Материал и методы. Имплантация клапана Ахмеда была проведена 10 детям в возрасте от 7 до 17 лет (10 глаз) с некомпенсированной на максимальном гипотензивном режиме открытоугольной или смешанной формой ПУГ. Ранее всем пациентам было выполнено в среднем 2,1±0,9 операций, направленных на нормализацию внутриглазного давления (ВГД). 6 глаз были артифакичными, 2 факичными, 2 афакичными. Имплантация клапана Ахмеда проводилась по общепринятой методике. ВГД на момент операции было в среднем 30,50±4,35 мм рт.ст. Компенсацией глаукомы считали ВГД≤24 мм рт.ст. и отсутствие симптомов прогрессирования глаукомного процесса. Срок наблюдения после операции составил от 3,9 до 23,6 месяцев (в среднем – 14,1±6,5). Результаты. Стойкий гипотензивный эффект вмешательства достигнут в 90% случаев, из них у 3 пациентов без гипотензивного режима, у 6 – на фоне препаратов. Среднее количество гипотензивных препаратов после операции составило 1,7±1,49 (значительно меньше по сравнению с периодом до операции, р=0,028). В конце периода наблюдения среднее значение ВГД составило 18,1±5,34 мм рт.ст. (р=0,008). Во время операции у 1 пациента после парацентеза отмечалось кровотечение из сосудов угла передней камеры, остановленное тампонадой стерильным воздухом. В остальных случаях вмешательство, ближайший и отдаленный послеоперационный период протекали без осложнений. Выводы. Имплантация клапана Ахмеда является эффективным и безопасным способом хирургического лечения рефрактерной ПУГ у детей и может быть рекомендована при неэффективности предшествующих антиглаукоматозных операций, в том числе пациентам с артифакией и афакией.

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