Abstract
ABSTRACTPurpose: To describe clinical results of Ahmed glaucoma valve implantation in Mexican patients with neovascular glaucoma (NVG).Materials and methods: We reviewed records of 60 eyes of 60 patients with NVG who underwent Ahmed valve implantation, with a follow-up period of 1 year. We identified successful and failed cases and compared baseline and follow-up characteristics to identify possible differences between both groups.Results: We classified 36 eyes (60%) as successful and 24 (40%) as failed cases. We found a significant difference in success rate in patients who had a hypertensive phase at any time during the follow-up period (OR = 5.15, CI = 1.49-20.15, p = 0.004). Patients in the success group showed a statistically significant decrease in the number of glaucoma medications 1 year after surgery (p <0.0001). We found a statistically significant difference in success rate in patients who had preoperative best corrected visual acuity (BCVA) better than logmar 0.70 (odds ratio 4.31, CI = 1.1-19.3, p = 0.03086).Conclusion: A hypertensive postoperative phase and a preoperative BCVA worse or equal to 20/100 seem to be risk factors for Ahmed valve surgical failure in patients with NVG.How to cite this article: Hernandez-Oteyza A, Lazcano-Gomez G, Jimenez-Roman J, Hernandez-Garciadiego C. Surgical Outcome of Ahmed Valve Implantation in Mexican Patients with Neovascular Glaucoma. J Curr Glaucoma Pract 2014;8(3):86-90.
Highlights
Glaucoma surgery can be classified as either filtering or cyclodestructive procedures
Neovascular glaucoma (NVG) frequently fails to respond to medical therapy, and trabeculectomy has a high likelihood for failure
Results of drainage implants in neovascular glaucoma (NVG) were first reported by Molteno,[8] but several, mainly retrospective, studies have described the results after Krupin implant, Baerveldt implant and Ahmed glaucoma valve.[3,4,9,10]
Summary
Glaucoma surgery can be classified as either filtering (increasing outflow) or cyclodestructive (reducing inflow) procedures. 1-3Department of Glaucoma, Association to Prevent Blindness in Mexico, Mexico. Corresponding Author: Alejandra Hernandez-Oteyza, Fellow Department of Glaucoma, Association to Prevent Blindness in Mexico, Mexico, Phone: 5215510841400, e-mail: ale.hdezoteyza@ gmail.com relative predictability.[1] Initially, tube shunts were used in eyes with limited visual potential, often in cases where trabeculectomy had already failed, or where trabecu lectomy was considered unlikely to succeed. As tube shunts have proven their effectiveness and have shown reduced complication rates compared to traditional filtering surgery, they are being considered more and more as an initial surgical intervention for many types of glaucoma.[2,3]. Neovascular glaucoma (NVG) frequently fails to respond to medical therapy, and trabeculectomy has a high likelihood for failure. Results of drainage implants in NVG were first reported by Molteno,[8] but several, mainly retrospective, studies have described the results after Krupin implant, Baerveldt implant and Ahmed glaucoma valve.[3,4,9,10] This study aims to evaluate the results of Ahmed glaucoma valve surgery in neovascular glaucoma in a Mexican population
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