J Korean Ophthalmol Soc.  2010 Feb;51(2):227-233. 10.3341/jkos.2010.51.2.227.

Ahmed Valve Implantation with Adjunctive Mitomycin C and 5-Fluorouracil: Outcomes at One Year

• Yoon HJ
• Park JJ

• KMID: 2213144
• DOI: http://doi.org/10.3341/jkos.2010.51.2.227

Abstract

PURPOSE
To evaluate the outcome after Ahmed valve implantation in patients with neovascular glaucoma when using intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU).
METHODS
A total of 40 eyes of 40 patients with neovascular glaucoma who received antiglacomatous medication without previous glaucoma surgery were included in the present study. The patients received Ahmed valve implantation and intraoperative MMC and postoperative 5-FU. Failure was defined as the first occurrence of any of the following: 1) the first of three consecutive visits where intraocular pressure (IOP) was >18 mmHg or 20% IOP reduction from baseline and the final number of topical medication did not reduce by at least two from baseline, 2) the need for additional surgery, or 3) the occurrence of a serious complication.
RESULTS
The cumulative success rate was 77.5% at 12 months. The final number of topical medication after Ahmed valve implantation was 0.73+/-0.78, and the change in the number of medication from baseline was -2.18+/-0.84. Serious complications such as endophthalmitis, valve exposure or prolonged hypotony were not observed.
CONCLUSIONS
The adjunctive use of intraoperative MMC and postoperative 5-FU with Ahmed valve implantation results in a high success rate and good IOP control and did not show serious complications within the postoperative period.

Keyword

Ahmed valve implantation; Complication; Neovascular glaucoma; Success rate

MeSH Terms

Endophthalmitis
Eye
Fluorouracil
Glaucoma
Glaucoma, Neovascular
Humans
Intraocular Pressure
Mitomycin
Postoperative Period
Fluorouracil
Mitomycin

Figure

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  Figure 1. Intraocular pressure (IOP) following Ahmed valve implantation with adjunctive intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU). *D=day †W=week; ‡M=month.

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  Figure 2. Kaplan-Meier estimates of the cumulative probability of valve success for Ahmed valve implanted eyes. Failure was defined as the first occurrence following an initial postoperative period of any of the following events: 1) IOP >18 mmHg for three consecutive visits or <20% IOP reduction from baseline and the final number of topical medications was not reduced by at least two from baseline, 2) need for additional surgery to repair a malfunctioning Ahmed valve, or 3) serious postoperative complication.

Reference

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