J Korean Ophthalmol Soc.  2012 Jun;53(6):801-806.

Vitrectomy and Ahmed Valve Implantation in Neovascular Glaucoma Patients with Vitreous Hemorrhage

• Moon DR
• Choi KS
• Lee SJ
• Ha SJ

Abstract

PURPOSE
To compare the surgical outcomes between sequential -and simultaneous combined vitrectomy and Ahmed valve implantation (AVI) in neovascular glaucoma (NVG) patients with vitreous hemorrhage.
METHODS
The medical records of 22 eyes of 22 patients, who had NVG with vitreous hemorrhage treated with vitrectomy and AVI, were retrospectively reviewed. Surgical success was defined as 6 mm Hg < or = IOP < or = 21 mm Hg, with or without the use of antiglaucoma medications and failure was defined as cases that had no light perception during the study period and which required additional surgery. The authors of the present study evaluated the surgical success rates and factors affecting surgical success between sequential and simultaneous combined vitrectomy and AVI.
RESULTS
The cumulative surgical success rate by the Kaplan-Meier survival analysis was 45% in sequential combined vitrectomy and AVI (group1), and 18% in combined vitrectomy and AVI (group 2), at 1 year, a significant difference. Preoperative panretinal photocoagulation was related to surgical success rate by Cox's regression model analysis.
CONCLUSIONS
Simultaneous combined vitrectomy and AVI is considered as a primary procedure in a patient who has NVG with vitreous hemorrhage. Panretinal photocoagulation in the preoperative periods, is thought to increase the surgical success rate.

Keyword

Ahmed valve implantation; Neovascular glaucoma; Panretinal photocoagulation; Vitrectomy

MeSH Terms

Eye
Glaucoma, Neovascular
Glycolates
Humans
Light
Light Coagulation
Medical Records
Preoperative Period
Retrospective Studies
Vitrectomy
Vitreous Hemorrhage
Glycolates

Figure

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  Figure 1 Changes in intraocular pressures in the 2 groups. Intraocular pressure: Significant difference at post-op 3, 6, 9, 12 months between the 2 groups. Group I = vitrectomy combined with AVI, Group II = AVI following vitrectomy. AVI = Ahmed valve implantation.

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  Figure 2 Changes in the number of eye drops in the 2 groups. Number of eye drops: No significant difference between the 2 groups. Group I = vitrectomy combined with AVI; Group II = AVI following vitrectomy. AVI = Ahmed valve implantation.

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  Figure 3 Changes in surgical success rate in the 2 groups. Surgical success rate: Significant difference at post op 9, 12 months between the 2 groups. Group I = vitrectomy combined with AVI; Group II = AVI following vitrectomy. AVI = Ahmed valve implantation.

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