A nonrandomized controlled study of inflammatory response between uveitic glaucoma and other refractory glaucoma following Ahmed glaucoma valve implantation

Abstract

Background The aqueous flare is obvious in uveitic glaucomatous eye due to the damage of blood-aqueous barrier, especially following intraocular surgery.How to quantitatively determine the aqueous flare is important for us to understand the severity of inflammatory response. Objective This study was to assess inflammatory response following Ahmed glaucoma valve implantation in uveitic glaucomatous eye. Methods A nonrandomized controlled study was carried out under the approval of Ethic Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University.Twenty-nine eyes of 29 subjects with refractory glaucoma were enrolled this hospital from October 2011 through July 2012.The patients were divided into the uveitic glaucoma group (10 eyes) and the other refractory glaucoma group (19 eyes) with the matched demography, and Ahmed glaucoma valve implantation was performed on all the eyes under the informed consent of each patient.The aqueous flare value was determined with FC-2000 flare-cell photometry and intraocular pressure (IOP) was measured with Goldmann tonometer before surgery and 1 day, 3 days, 1 week, 2 weeks, 1 month and 3 months after surgery.The outcomes were compared between the two groups, and the correlation of aqueous flare value with IOP was analyzed. Results In the uveitic glaucoma group, the aqueous flare values were 21.10 (10.50, 38.58) photoparticles/ms, 88.00 (23.55, 168.63) photoparticles/ms and 29.90 (8.90, 65.18)photoparticles/ms 1 day, 3 days and 1 week after surgery, which were significantly higher than 13.53 (7.60, 24.00) photoparticles/ms before surgery (all at P 0.05). Also, no significant correlations were seen between IOP and aqueous flare value in all patients at various time points (preoperation: rs=0.136, P=0.481; postoperative 1 day: rs=0.019, P=0.922; postoperative 3 days: rs=-0.035, P=0.858; postoperative 1 week: rs=0.317, P=0.094; postoperative 2 weeks: rs=0.034, P=0.861; postoperative 1 month: rs= -0.094, P=0.628; postoperative 3 months: rs=0.065, P=0.738). Conclusions FC-2000 flare-cell photometry can reflect the inflammatory reaction of the anterior chamber following Ahmed glaucoma valve implantation in various types of refractory glaucomatous eyes.The postoperative inflammatory response is more serious and lasting in uveitic glaucomatous eye. Key words: Uveitic glaucoma/surgery; Glaucoma drainage implants; Aqueous humor/cytology; Lasers/diagnostic use; Photometry/method; Intraocular pressure; Blood-aqueous barrier; Ahmed glaucoma valve implantation