Background Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation （AGVI） in neovascular glaucoma （NVG...Background Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation （AGVI） in neovascular glaucoma （NVG） and non- NVG patients. Methods This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG （NVG group） and 28 had non-NVG （non-NVG group）. All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab （IVR/IVB） before AGVI. Intraocular pressure （lOP） was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity （BCVA）, and postoperative complications were analyzed between the groups. Results All of the patients completed the study （follow-up of 12 months）. Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant （P=-0.036）. The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively （P=0.049）. Compared with preoperative examinations, the postoperative mean lOP and use of medications were significantly lower at all follow-up time points in both groups （all P 〈0.05）. There were significant differences in BCVA between the two groups at the 12-month follow-up （X2=9.86, P=0.020）. Cox proportional hazards regression showed NVG as a risk factor for surgical failure （RR=15.08, P=0.033）. Postoperative complications were similar between the two groups. Conclusions AGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.展开更多
AIM:To evaluate the long-term results and complications of ahmed glaucoma valve (AGV) implantation in refractory glaucoma.· METHODS:A retrospective review of 13 patients (13 eyes) with refractory glaucoma who und...AIM:To evaluate the long-term results and complications of ahmed glaucoma valve (AGV) implantation in refractory glaucoma.· METHODS:A retrospective review of 13 patients (13 eyes) with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 18 months was performed.All patients underwent a complete ophthalmologic examination and intraocular pressure (IOP) measurement before surgery and at 1 month,3 months,6 months,1 year after surgery and yearly afterwards.Complications and the number of antiglaucoma medications needed were recorded.· RESULTS:Mean age was 27.3±16.0 years.All eyes (100%) had at least one prior incisional surgery.Mean follow-up was 61.3±30.8 months.IOP was reduced from a mean of 35.0±7.0mmHg to 18.2±7.9mmHg at 12 months and to 17.0±4.1mmHg at 96 months (P <0.05) with a lower number of medications from baseline,76.9% patients required additional procedures to achieve the success criteria set by previously published series.The most common complications were encapculated cyst formation in eight eyes (61.5%) and tube exposure in four eyes (30.8%).· CONCLUSION:Encapsulated cyst formation was the most common complication which hindered succesful IOP control after AGV implant insertion for refractory glaucoma.Despite cyst excision with anti-fibrotic agents,successful IOP reduction was not achieved in 76.9% of the patients without antiglaucoma medication.展开更多
基金This research was supported by grants from the National Natural Science Foundation of China （No. 81371008） and the Science and Technology Planning Project of Guangdong Province, China （No. 2012B031800353）.
文摘Background Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation （AGVI） in neovascular glaucoma （NVG） and non- NVG patients. Methods This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG （NVG group） and 28 had non-NVG （non-NVG group）. All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab （IVR/IVB） before AGVI. Intraocular pressure （lOP） was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity （BCVA）, and postoperative complications were analyzed between the groups. Results All of the patients completed the study （follow-up of 12 months）. Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant （P=-0.036）. The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively （P=0.049）. Compared with preoperative examinations, the postoperative mean lOP and use of medications were significantly lower at all follow-up time points in both groups （all P 〈0.05）. There were significant differences in BCVA between the two groups at the 12-month follow-up （X2=9.86, P=0.020）. Cox proportional hazards regression showed NVG as a risk factor for surgical failure （RR=15.08, P=0.033）. Postoperative complications were similar between the two groups. Conclusions AGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.
文摘AIM:To evaluate the long-term results and complications of ahmed glaucoma valve (AGV) implantation in refractory glaucoma.· METHODS:A retrospective review of 13 patients (13 eyes) with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 18 months was performed.All patients underwent a complete ophthalmologic examination and intraocular pressure (IOP) measurement before surgery and at 1 month,3 months,6 months,1 year after surgery and yearly afterwards.Complications and the number of antiglaucoma medications needed were recorded.· RESULTS:Mean age was 27.3±16.0 years.All eyes (100%) had at least one prior incisional surgery.Mean follow-up was 61.3±30.8 months.IOP was reduced from a mean of 35.0±7.0mmHg to 18.2±7.9mmHg at 12 months and to 17.0±4.1mmHg at 96 months (P <0.05) with a lower number of medications from baseline,76.9% patients required additional procedures to achieve the success criteria set by previously published series.The most common complications were encapculated cyst formation in eight eyes (61.5%) and tube exposure in four eyes (30.8%).· CONCLUSION:Encapsulated cyst formation was the most common complication which hindered succesful IOP control after AGV implant insertion for refractory glaucoma.Despite cyst excision with anti-fibrotic agents,successful IOP reduction was not achieved in 76.9% of the patients without antiglaucoma medication.
