Long-term Clinical and Functional Results of Neovascular Glaucoma Surgical Treatment with Glautex Drainage and Ahmed Valve

Abstract

Purpose — to determine the effect of fistulizing operations with Glautex drainage and Ahmed valve implantation in the cases with neovascular glaucoma within 3 years. Patients and methods. We observed 44 patients (44 eyes) with secondary neovascular glaucoma on the background of post-thrombotic and proliferative diabetic retinopathy. Patient age averaged 60,84±1,29 years. Males — 19, females — 25. The patients were divided into two groups depending on the used drainages and drainage devices. In Group I the standard sinus trabeculectomy with Glautex drainage was performed in 23 patients. The II group included 21 patients who were implanted Ahmed valve. Results. According to the results of our research the relative hypotensive effect was in groups I and II, respectively, 52.2% (12/23) and 79.4% (17/21) 1 year after surgery; 43.5% (10/23) and 71.4% (15/21) — 2 years after surgery; 39.1% (9/23) and 66.7% (14/21) — after 3 years of follow up. The maximum decrease in IOP was observed immediately after surgery in the analyzed groups, 66.8% and 64.5%, respectively. There was no surgical treatment effect for 3 years in Group I in 60.8% (14/23), in group II — 33.3% (7/21) of the cases. Conclusion. The analysis of clinical and functional results of surgical treatment of patients with neovascular glaucoma in terms of 3 years follow up showed that the most lasting preservation of visual function and the hypotensive effect was achieved after implantation of the Ahmed valve — in 66.7% of the cases. In the cases of sinus trabeculectomy with Glautex drainage — in 39.1% of the cases. The incidence of postoperative complications in both groups was comparable: as hyphema, hypotension, and the eruption of implants developed after sinus trabeculectomy with Glautex drainage in 26.1%, 21.7% and 4.3%, respectively, after Ahmed valve implantation in 23 8%, 19.1% and 9.6% of the cases.