Pars plana Ahmed valve implant and vitrectomy in the management of neovascular glaucoma.

Abstract

BACKGROUND AND OBJECTIVE:

To evaluate the efficacy and safety of the pars plana Ahmed glaucoma valve (New World Medical, Inc., Rancho Cucamonga, CA) implant combined with pars plana vitrectomy and panretinal photocoagulation for the management of neovascular glaucoma in patients with vitreous hemorrhage.

PATIENTS AND METHODS:

The records of 18 eyes of 17 consecutive patients with neovascular glaucoma who had undergone pars plana vitrectomy and pars plana Ahmed valve implant were evaluated. The patients were observed for a mean time of 14.2 months (range, 6 to 28 months).

RESULTS:

Mean preoperative intraocular pressure with oral and two or three topical antiglaucoma medications was 53.3 +/- 10 mm Hg, and mean postoperative intraocular pressure without oral antiglaucoma medications was 16.3 +/- 7.1 mm Hg (P < .0001) at the final visit. Overall success rate was 72.2%, defined as an intraocular pressure of 5 to 21 mm Hg with or without antiglaucoma medication. A postoperative hypertensive phase occurred in 7 patients (38.8%), of which all but one responded to medical therapy. Visual acuity was stabilized or improved in 77.7% of the eyes. There was one case of each of the following adverse events: mild vitreous cavity hemorrhage, hypotony, choroidal effusion, epiretinal membrane, corneal edema, and corneal ulcer. Two cases developed phthisis bulbi and lost light perception.

CONCLUSIONS:

Pars plana vitrectomy and Ahmed valve implantation seems to be a viable surgical modality in the management of neovascular glaucoma and coexisting posterior segment pathology with a relatively low rate of serious permanent postoperative complications.

• Authors: Hooshang Faghihi, Fedra Hajizadeh, Seyed-Farzad Mohammadi, Arezoo Kadkhoda, Gholam A Peyman, Mohammad Riazi-Esfahani
• Journal: Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye (Ophthalmic Surg Lasers Imaging) 2007 Jul-Aug Vol. 38 Issue 4 Pg. 292-300 ISSN: 1542-8877 [Print] United States
• PMID: 17674919 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Glaucoma Drainage Implants
• Glaucoma, Neovascular (complications, surgery)
• Humans
• Intraocular Pressure
• Laser Coagulation
• Male
• Middle Aged
• Prosthesis Implantation
• Treatment Outcome
• Visual Acuity
• Vitrectomy
• Vitreous Hemorrhage (complications, surgery)