J Korean Ophthalmol Soc.  2022 Feb;63(2):183-190. 10.3341/jkos.2022.63.2.183.

Surgical Outcomes of the Ahmed Valve Implantation Following Trans-scleral Cyclophotocoagulation

• Jeon Y
• Kim J
• Nam KY
• Hwang YH
• Kim KN

• KMID: 2526508
• DOI: http://doi.org/10.3341/jkos.2022.63.2.183

Abstract

Purpose
To determine the intraocular pressure (IOP) lowering effect and complications of Ahmed valve implantation (AGV) in patients who underwent cyclophotocoagulation (CPC).
Methods
Patients who underwent AGV after CPC in group 1, those who underwent CPC after AGV in group 2, and patients who underwent repeated CPC in group 3 were included in this retrospective observational study. Changes in IOP, number of glaucoma eye drops, and best corrected visual acuity (BCVA) were analyzed before and 1 week, 1 month, 3 months, 6 months, and 12 months after surgery, and postoperative complications were analyzed.
Results
Eight patients in group 1, 10 patients in group 2, and seven patients in group 3 were included in the analysis. Preoperative IOP was 45.6 ± 15.5, 29.3 ± 5.6, and 43.4 ± 14.4 mmHg in the three groups, respectively, and the number of glaucoma eye drops was 3.8 ± 0.7, 3.9 ± 0.3, and 3.7 ± 1.0 in the three groups, respectively. At 12 months postoperatively, IOP decreased significantly in all three groups compared to preoperatively (all p < 0.05), and the number of glaucoma eye drops was also significantly reduced (all p < 0.05). Among patients with preoperative BCVA of 0.02 decimal or higher, postoperative BCVA decreased in two patients in group 2 and one in group 3 (p = 0.380). Hypotony occurred in one patient in group 1 and two patients in group 3 (p = 0.383), and among them, one patient in group 1 and one patient in group 3 progressed to the phthisis (p = 0.940).
Conclusions
In patients whose IOP cannot be controlled after CPC, AGV is expected to be used as a relatively safe and effective treatment method for lowering IOP.

Keyword

Ahmed valve implantation; Cyclophotocoagulation; Glaucoma; Intraocular pressure