J Retin.  2024 May;9(1):18-23. 10.21561/jor.2024.9.1.18.

Surgical Results of 25-gauge Microincision Vitrectomy in Patients with a Glaucoma Drainage Implant

• Kim W
• Kim S
• Lee S

• KMID: 2556463
• DOI: http://doi.org/10.21561/jor.2024.9.1.18

Abstract

Purpose
To evaluate the clinical outcomes of 25-gauge microincision vitrectomy for vitreoretinal diseases in patients who have undergone glaucoma drainage implant surgery for the treatment of neovascular glaucoma.
Methods
We retrospectively examined the preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and complications of patients with previous Ahmed valve implantation surgery who underwent vitrectomy and were available for follow-up for at least 6 months.
Results
A total of 20 eyes had Ahmed valve implantation for neovascular glaucoma, of which 16 eyes (80%) had proliferative diabetic retinopathy, and 4 eyes (20%) had central retinal vein occlusion. All eyes underwent 25-gauge microincision vitrectomy for the treatment of vitreous hemorrhage unresponsive to conservative treatment. BCVA (logarithm of minimal angle of resolution, logMAR) improved from 1.08 ± 0.29 preoperatively to 0.61 ± 0.32 (p = 0.004) postoperatively. Mean IOP increased from 16.2 ± 3.4 mmHg preoperatively to 17.4 ± 2.8 mmHg at 6 months postoperatively (p = 0.569), with no significant change. There were no cases of exposed body or tube of Ahmed valve after surgery, and vitreous hemorrhage (7 eyes, 31.8%) was the most common complication.
Conclusions
With a carefully chosen incision site, 25-gauge microincision vitrectomy is an effective treatment method to treat vision-threatening complications such as vitreous hemorrhage in eyes previously implanted with a glaucoma drainage device, with minimal impact on elevated intraocular pressure.

Keyword

Glaucoma drainage implants; Glaucoma, Neovascular; Vitrectomy