Abstract
Purpose
To compare the safety and efficacy of the FP8 AGV (paediatric) with the standard FP7 AGV in adult post-vitreoretinal (VR) surgery glaucoma.
Methods
We included 45 consecutive eyes with post-VR surgery glaucoma implanted with either FP8 (n = 28) or FP7 (n = 17) AGV between 2008 and 2016. The data analysed included visual acuity (VA), intraocular pressure (IOP), complications, interventions, and outcomes.
Results
Mean age (p = 0.24), mean baseline VA (p = 0.77), preoperative IOP (p = 0.41), number of antiglaucoma medications (p = 0.92), and previous surgeries (p = 0.16) were comparable in the two groups. The number of eyes with previous belt buckle was significantly higher (p < 0.001) in the FP8 group (17/28) compared with the FP7 group (2/17), indicating space constraint and scarred conjunctiva. The median follow-up (25th, 75th percentile) was 14.7 (9.1, 25.3) months in the FP7 and 9.8 (6.4, 34.7) months in the FP8 groups (p = 0.62). Postoperatively, the median VA (p = 0.24), the mean IOP at final follow-up (p = 0.15), and median number of AGM (p = 0.99) were comparable in both the groups. The median percentage drop in IOP (95% confidence interval) with the FP7 implant was 55% (43.70%) and with FP8 implant was 53.8% (25, 73), (p = 0.20). None in the FP7 group failed, while three eyes in the FP8 group failed. During the study period, two eyes in the FP8 group had tube exposure that was surgically managed. None of the eyes had implant exposure or loss of light perception.
Conclusion
Use of the paediatric FP8 AGV in adult post-VR surgery glaucoma eyes with severe conjunctival scarring and limited subconjunctival space resulted in reasonable IOP control compared with the standard FP7 AGV implant. There were no eyes with implant extrusion.
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References
Gedde SJ. Management of glaucoma after retinal detachment surgery. Curr Opin Ophthalmol. 2002;13:103–9.
Singh D, Chandra A, Sihota R, Kumar S, Gupta V. Long-term success of mitomycin-augmented trabeculectomy for glaucoma after vitreoretinal surgery with silicone oil insertion: a prospective case series. Retina. 2014;34:123–8.
Rotchford AP, Jayasawal R, Madhusudhan S, Ho S, King AJ, Vernon SA. Transscleral diode laser cycloablation in patients with good vision. Br J Ophthalmol. 2010;94:1180–3.
Sivagnanavel V, Ortiz-Hurtado A, Williamson TH. Diode laser trans-scleral cyclophotocoagulation in the management of glaucoma in patients with long-term intravitreal silicone oil. Eye. 2005;19:253–7.
Ghazi-Nouri SM, Vakalis AN, Bloom PA, Bunce C, Charteris DG. Long-term results of the management of silicone oil-induced raised intraocular pressure by diode laser cycloablation. Eye. 2005;19:765–9.
Scott IU, Gedde SJ, Budenz DL, Greenfield DS, Flynn HW Jr, Feuer WJ, et al. Baerveldt drainage implants in eyes with a preexisting scleral buckle. Arch Ophthalmol. 2000;118:1509–13.
Choudhari NS, George R, Shantha B, Neog A, Tripathi S, Srinivasan B, et al. Ahmed glaucoma valve in eyes with preexisting episcleral encircling element. Indian J Ophthalmol. 2014;62:570–4.
Gupta S, Chaurasia AK, Chawla R, Kapoor KS, Mahalingam K, Swamy DR, et al. Long-term outcomes of glaucoma drainage devices for glaucoma post-vitreoretinal surgery with silicone oil insertion: a prospective evaluation. Graefe’s Arch Clin Exp Ophthalmol. 2016;254:2449–54.
Latina MA, Gulati V. A modification of the Ahmed valve for tight places. Ophthalmic Surg, Lasers Imag. 2003;34:396–7.
Law RW, Li RT, Lai JS, Rao SK, Lam DS. Modification of an adult-sized Ahmed glaucoma valve for a small globe. Jpn J Ophthalmol. 2006;50:67–8.
Koh KM, Hwang YH, Jung JJ, Sohn YH, Kim HK. Comparison of the outcome of silicone Ahmed glaucoma valve implantation with a surface area between 96 and 184 mm(2) in adult eyes. Korean J Ophthalmol. 2013;27:361–7.
Smith MF, Doyle JW, Fanous MM. Modified aqueous drainage implants in the treatment of complicated glaucomas in eyes with pre-existing episcleral bands1. Ophthalmology. 1998;105:2237–42.
Smith SL, Starita RJ, Fellman RL, Lynn JR. Early clinical experience with the Baerveldt 350-mm2 glaucoma implant and associated extraocular muscle imbalance. Ophthalmology. 1993;100:914–8.
Schwartz KS, Lee RK, Gedde SJ. Glaucoma drainage implants: a critical comparison of types. Curr Opin Ophthalmol. 2006;17:181–9.
Minckler DS, Vedula SS, Li TJ, Mathew MC, Ayyala RS, Francis BA. Aqueous shunts for glaucoma. Cochrane Database Syst. Rev. 2006:CD004918.
Lloyd MA, Baerveldt G, Fellenbaum PS, Sidoti PA, Minckler DS, Martone JF, et al. Intermediate-term results of a randomized clinical trial of the 350- versus the 500-mm2 Baerveldt implant. Ophthalmology. 1994;101:1456–63. Discussion 63–4.
Roy S, Ravinet E, Mermoud A. Baerveldt implant in refractory glaucoma: long-term results and factors influencing outcome. Int Ophthalmol. 2001;24:93–100.
Seah SK, Gazzard G, Aung T. Intermediate-term outcome of Baerveldt glaucoma implants in Asian eyes. Ophthalmology. 2003;110:888–94.
Sidoti PA, Dunphy TR, Baerveldt G, LaBree L, Minckler DS, Lee PP, et al. Experience with the Baerveldt glaucoma implant in treating neovascular glaucoma. Ophthalmology. 1995;102:1107–18.
Siegner SW, Netland PA, Urban RC Jr, Williams AS, Richards DW, Latina MA, et al. Clinical experience with the Baerveldt glaucoma drainage implant. Ophthalmology. 1995;102:1298–307.
Hwang JM, Kee C. The effect of surface area expansion with pericardial membrane (preclude) in Ahmed glaucoma valve implant surgery. J Glaucoma. 2004;13:335–9.
Al-Jazzaf AM, Netland PA, Charles S. Incidence and management of elevated intraocular pressure after silicone oil injection. J Glaucoma. 2005;14:40–6.
Dubey S, Prasanth B, Acharya MC, Narula R. Conjunctival erosion after glaucoma drainage device surgery: a feasible option. Indian J Ophthalmol. 2013;61:355–7.
Kiranmaye T, Garudadri CS, Senthil S. Role of oral doxycycline and large diameter bandage contact lens in the management of early post-trabeculectomy bleb leak. BMJ Case Rep. 2014;2014.
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Turaga, K., Rao, A., Ali, M.H. et al. Safety and efficacy of paediatric silicone Ahmed glaucoma valve (AGV) in adult eyes with post-VR surgery glaucoma. Eye 34, 1121–1128 (2020). https://doi.org/10.1038/s41433-019-0663-0
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DOI: https://doi.org/10.1038/s41433-019-0663-0


