J Korean Ophthalmol Soc.  2012 May;53(5):668-673.

Comparison of Surgical Outcomes between Trabeculectomy and Aqueous Shunt Surgery in Patients with Iridocorneal Endothelial Syndrome

• Kim JL
• Yang JW

Abstract

PURPOSE
To compare surgical outcomes and corneal endothelial cell densities in patients with glaucoma secondary to iridocorneal endothelial (ICE) syndrome who underwent trabeculectomy with mitomycin-C (MMC) versus those who underwent Ahmed Glaucoma Valve (AGV) implantation.
METHODS
Twenty-one patients with ICE syndrome who underwent either trabeculectomy with MMC or AGV implantation were included in this study. All patients had more than 12 months of follow-up after glaucoma surgery. Intraocular pressure (IOP), visual acuity (VA) and corneal endothelial cell density were compared according to the method of surgery.
RESULTS
Ten eyes had undergone a trabeculectomy with MMC, and 11 eyes had an AGV implantation. In eyes that underwent a trabeculectomy with a MMC, there were no statistically significant differences between preoperative and postoperative month 12 in IOP, VA or corneal endothelial cell density. In eyes that underwent AGV implantation, postoperative IOP, VA and corneal endothelial cell density were statistically significantly lower than the preoperative values.
CONCLUSIONS
When determining the method of glaucoma surgery in patients with ICE syndrome, the additional procedures needed to maintain the surgical success of trabeculectomy with MMC and the corneal decompensation which is caused by a decrease in corneal endothelial cell density after AGV implantation should be considered.

Keyword

Ahmed valve implantation; Corneal endothelial cell density; Iridocorneal endothelial syndrome; Trabeculectomy

MeSH Terms

Endothelial Cells
Eye
Follow-Up Studies
Glaucoma
Glaucoma Drainage Implants
Humans
Ice
Intraocular Pressure
Iridocorneal Endothelial Syndrome
Mitomycin
Trabeculectomy
Visual Acuity
Ice
Mitomycin

Figure

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  Figure 1 The changes in mean intraocular pressure (IOP) during the follow-up period. *Significantly higher intraocular pressure between the 2 groups (p < 0.05, independent t-test).

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  Figure 2 The changes in visual acuity in the groups during the follow-up period. There is no significant difference between the two groups at all the time points.

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  Figure 3 The changes in corneal endothelial cell counts in the groups during the follow-up period. There is no significant difference between two groups at all the time points.

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