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Peter A Netland - One of the best experts on this subject based on the ideXlab platform.
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trabeculectomy versus ahmed Glaucoma Valve implantation in neovascular Glaucoma
Clinical Ophthalmology, 2011Co-Authors: Christopher C Shen, Sarwat Salim, Peter A NetlandAbstract:Purpose: To compare surgical outcomes in neovascular Glaucoma patients who underwent trabeculectomy with mitomycin C versus Ahmed Glaucoma Valve implantation.
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The Ahmed Glaucoma Valve in patients with and without neovascular Glaucoma.
Journal of glaucoma, 2010Co-Authors: Peter A Netland, Kyoko Ishida, John W. BoyleAbstract:Purpose To evaluate the results of Ahmed Glaucoma Valve surgery in neovascular Glaucoma and control patients. Patients and methods In this retrospective comparative study, we reviewed 76 eyes of 76 patients, comparing the surgical outcomes in control patients (N=38) to matched neovascular Glaucoma patients (N=38). Success was defined as intraocular pressure (IOP) ≥6 mm Hg and ≤21 mm Hg, without further Glaucoma surgery, and without loss of light perception. Results Average follow-up for control and neovascular Glaucoma patients was 18.4 and 17.4 months, respectively (P=0.550). The mean IOPs were 17.9±8.4 mm Hg and 16.5±15.8 mm Hg at 1-year (P=0.150), and 18.4±11.2 mm Hg and 9.9±6.3 mm Hg at 2 years (P=0.057) in controls and eyes with neovascular Glaucoma, respectively. Life-table analysis showed a significantly lower success for neovascular Glaucoma patients compared with controls (P=0.0096), with success at 1 year=89.2% and 73.1%, 2 years=81.8% and 61.9%, and 5 years=81.8% and 20.6% for control and neovascular Glaucoma eyes, respectively. Cox proportional hazard regression analysis showed neovascular Glaucoma as a risk factor for surgical failure (odds ratio=5.384, 95% CI=1.22-23.84, P=0.027). Although IOP control and complications were comparable between the 2 groups, visual outcomes were worse in neovascular Glaucoma patients, with 9 (23.7%) eyes with neovascular Glaucoma compared with no controls losing light perception vision (P=0.002). The majority with loss of vision (5 of 9) had successful control of IOP during the postoperative period. Conclusions Neovascular Glaucoma patients have greater risk of surgical failure after Ahmed Glaucoma Valve surgery compared with controls. Despite improved IOP with drainage implants, visual outcomes may be poor, probably owing to progression of underlying disease.
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ahmed Glaucoma Valve surgical outcomes in eyes with and without silicone oil endotamponade
Journal of Glaucoma, 2009Co-Authors: Kyoko Ishida, Iqbal Ike K Ahmed, Peter A NetlandAbstract:PURPOSE: To compare the results of Ahmed Glaucoma Valve (AGV) implantation in eyes containing silicone oil to those without silicone oil. METHODS: This was a multicenter, retrospective, comparative study of 94 eyes in 94 patients with mean follow-up of 2 years, comparing surgical outcomes in eyes with silicone oil (N=47) to matched patients without silicone oil (N=47). Success was defined as intraocular pressure (IOP) of >/=6 and Glaucoma medicines, and without further Glaucoma surgery or loss of light perception. RESULTS: The mean IOP and number of medications at the last follow-up were comparable between the 2 groups (P=0.26 and P=0.12). The cumulative probability of success by life-table analysis was 85% at 6 months, 80% at 1 year, 70% at 2 and 3 years, and 47% at 4 years in silicone oil group, and 100% at 6 months and 1 year, and 76% at 2, 3, and 4 years in the control group (P=0.03). Complications were similar in the 2 groups (P=0.663). The duration of postoperative topical steroid use was significantly longer in the silicone oil group (P=0.0003). Silicone oil was identified as a risk factor for surgical failure by the Cox hazard model (risk ratio=3.43; P=0.04). CONCLUSIONS: The AGV can control the IOP in the majority of eyes after pars plana vitrectomy and silicone oil injection. However, the presence of silicone oil is associated with increased risk of surgical failure in eyes treated with the AGV.
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The Ahmed Glaucoma Valve in Neovascular Glaucoma (An AOS Thesis)
Transactions of the American Ophthalmological Society, 2009Co-Authors: Peter A NetlandAbstract:PURPOSE To evaluate the results of Ahmed Glaucoma Valve surgery in neovascular Glaucoma and control patients. METHODS In this retrospective comparative study, we reviewed 76 eyes of 76 patients, comparing the surgical outcomes in control patients (N=38) to matched neovascular Glaucoma patients (N=38). Success was defined as intraocular pressure (IOP) > or =6 mm Hg and < or =21 mm Hg, without further Glaucoma surgery, and without loss of light perception. RESULTS Average follow-up for control and neovascular Glaucoma patients was 18.4 and 17.4 months, respectively (P = .550). At last follow-up, mean IOP was 16.2 +/- 5.2 mm Hg and 15.5 +/- 12.5 mm Hg (P = .115) in control and neovascular Glaucoma patients, respectively. Life-table analysis showed a significantly lower success for neovascular Glaucoma patients compared with controls (P = .0096), with success at 1 year of 89.2% and 73.1%, at 2 years of 81.8% and 61.9%, and at 5 years of 81.8% and 20.6% for control and neovascular Glaucoma eyes, respectively. Cox proportional hazards regression analysis showed neovascular Glaucoma as a risk factor for surgical failure (odds ratio, 5.384, 95% CI, 1.22-23.84, P = .027). Although IOP control and complications were comparable between the two groups, visual outcomes were worse in neovascular Glaucoma patients, with 9 eyes (23.7%) with neovascular Glaucoma compared with no controls losing light perception vision (P = .002). The majority with loss of vision (5 of 9) had successful control of IOP during the postoperative period. CONCLUSION Neovascular Glaucoma patients have greater risk of surgical failure after Ahmed Glaucoma Valve surgery compared with controls. Despite improved mean IOP with drainage implants, visual outcomes may be poor, possibly due to progression of underlying disease.
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long term results of ahmed Glaucoma Valve implantation for uveitic Glaucoma
American Journal of Ophthalmology, 2007Co-Authors: Thekla Papadaki, Peter A Netland, Ioannis Zacharopoulos, Louis R Pasquale, William B Christen, Stephen C FosterAbstract:Purpose To present long-term outcomes of Ahmed Glaucoma Valve implantation for uveitic Glaucoma. Design Interventional case series. Methods Retrospective chart review of 60 patients (60 eyes) with uveitic Glaucoma who underwent Ahmed Valve implantation over a four-year period at a tertiary uveitis referral center. Success definition 1 included patients with an intraocular pressure (IOP) between 5 and 21 mm Hg, reduced by 25% from that before implantation. Success definition 2 (qualified success) excluded those patients in whom serious complications occurred. Results Mean follow-up time was 30 months (range, six to 87 months; four-year results relate to a cohort of 15 patients). Success rates were 77% and 50% and qualified success rates were 57% and 39% at one and four years, respectively. At four years, 74% of the patients required Glaucoma medication to maintain IOP control. The overall complication rate was 12%/person-years. The rate of visual acuity loss was 4%/person-years; that was most commonly attributed to corneal complications that were more likely to occur in patients with preoperative corneal disease (P = .01, Fisher exact test). Conclusions Ahmed Glaucoma Valve implantation is a safe yet moderately successful procedure for uveitic Glaucoma. Long-term success rates are enhanced with the use of Glaucoma medications, and corneal complications are the most common of all potential serious complications.
Anne L Coleman - One of the best experts on this subject based on the ideXlab platform.
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strabismus after ahmed Glaucoma Valve implantation
American Journal of Ophthalmology, 2021Co-Authors: Laura Robbins, Anne L Coleman, Kouros Nourimahdavi, Toshiaki Goseki, Simon Law, Joseph Caprioli, Joann A Giaconi, Joseph L Demer, Federico G Velez, Stacy L PinelesAbstract:Purpose Most reports of strabismus after Glaucoma drainage device implantation study larger devices and rarely note the incidence of strabismus after Ahmed Glaucoma Valve (AGV) implantation. It is unknown if the pattern of strabismus is similar with smaller devices. We investigated characteristics of strabismus after AGV implantation. Design Retrospective review. Methods Institutional study of 732 patients at our institution undergoing AGV implantation between 2013 and 2018. Rate and characteristics of strabismus were the primary outcome; age, gender, and location of AGVs were also analyzed. Results We identified 29 patients who developed new-onset strabismus postoperatively after initial AGV implantation, for 4% incidence of strabismus. Twenty-one (72%) of these had diplopia. AGVs were implanted superotemporally in 21, superonasally in 5, inferotemporally in 1, and inferonasally in 2. Three patients were esotropic, 11 were exotropic, 4 had hypertropia, 2 had hypotropia, and 9 patients had combined horizontal/vertical strabismus (esotropia/hypotropia [n = 1] or exotropia/hypertropias [n = 8]). Exotropia was the most common type of strabismus in both the superotemporal and superonasal (60%) AGV groups. Superotemporal AGVs were more commonly associated with ipsilateral hypertropia (43%) than superonasal AGVs. Treatments included strabismus surgery (n = 14), prisms (n = 6), or an occlusive lens (n = 1). Discussion. In the largest single-center series of patients undergoing initial AGV implantation, the overall incidence of postoperative strabismus was 4%. This is comparable to strabismus incidence following implantation of other types of Glaucoma drainage devices, even larger devices. The possibility of this complication should be discussed with patients prior to surgery.
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ahmed Glaucoma Valve in children a review
Saudi Journal of Ophthalmology, 2011Co-Authors: Nariman Nassiri, Kouros Nourimahdavi, Anne L ColemanAbstract:Pediatric Glaucoma is potentially a blinding disease. Although goniotomy and trabeculotomy are associated with good early success rates, eventually 20% of these procedures fail and many children will require additional surgery to control the IOP in the long-term. In this review, we reported that adequate IOP control can be achieved with the placement of Ahmed Glaucoma Valve and can last 5 or more years. However, most patients will need one or more Glaucoma medications at some point after surgery. In addition, the implants may be associated with pupillary irregularities, lenticular opacification as well as tube-related complications, particularly in the first year of life, as the globe is enlarging with age.
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outcomes of ahmed Glaucoma Valve implantation in children with primary congenital Glaucoma
Archives of Ophthalmology, 2009Co-Authors: Simon Law, Anne L Coleman, Joseph CaprioliAbstract:Objectives To evaluate the long-term efficacy of intraocular pressure reduction and complications of Ahmed Glaucoma Valve (AGV) implantation in children with primary congenital Glaucoma. Methods The medical records of patients with primary congenital Glaucoma who underwent AGV implantation with a minimum follow-up of 6 months were reviewed. The primary outcome measure was cumulative probability of success, defined as intraocular pressure greater than 5 mm Hg and less than 23 mm Hg and at least a 15% reduction from the preoperative intraocular pressure, without serious complications, additional Glaucoma surgery, or loss of light perception. Results Thirty eyes of 19 children with primary congenital Glaucoma who underwent AGV implantation with a minimum follow-up of 6 months were reviewed. The children had a mean (SD) age of 1.8 (2.6) years, a mean (SD) preoperative intraocular pressure of 28.4 (6.7) mm Hg, and a mean (SD) follow-up time of 57.6 (48.0) months. The cumulative probability of success was 63% in 1 year and 33% in 5 years. After a second AGV implantation, the cumulative probability of success was 86% in 1 and 2 years and 69% in 5 years. Hispanic ethnicity ( P = .02) and being female ( P = .005) were associated with increased risk of failure. Conclusions Thirty-three percent of AGV implantations in children with primary congenital Glaucoma were successful after 5 years of follow-up. With the implantation of a second AGV, the 5-year success rate increased to 69%.
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dynamic tube movement of ahmed Glaucoma Valve
Journal of Glaucoma, 2009Co-Authors: Simon Law, Anne L Coleman, Joseph CaprioliAbstract:PURPOSE To report the dynamic movement of the tube of the Ahmed Glaucoma Valve (AGV) in the anterior chamber with eye movement. PATIENTS AND METHODS Three patients (eyes) with dynamic movement of the tube of the AGV out of approximately 1500 AGV implantations over 10 years were identified. Demographic information, management, and patient outcomes were abstracted from the medical records. Possible mechanisms of the tube movement are discussed. RESULTS In all 3 eyes, the fibrovascular capsule and the plate were noted to be stationary in the superior temporal fornix under the conjunctiva and did not move with movement of the eye. The length of the intraocular portion of the tube varied between 3 and 4 mm, depending on the position of the globe. All 3 eyes had undergone at least 1 intraocular procedure before AGV implantation and 2 of 3 eyes had at least 1 intraocular procedure after the AGV implantation. The dynamic movement of the tube was first observed from 0.5 to 7 years after the AGVs were implanted. It was not associated with any intraocular reaction, damage of intraocular tissue, or decrease of intraocular pressure control, and no additional surgical intervention has been required. CONCLUSIONS Dynamic movement of the tube of AGV results from dissociation of the fibrovascular capsule and the plate in the fornix from the rotation of the globe. The length of the intraocular portion of the tube may vary widely with eye movement.
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long term outcomes of ahmed Glaucoma Valve implantation in refractory Glaucomas
American Journal of Ophthalmology, 2007Co-Authors: Carlos Souza, Anne L Coleman, Simon Law, Duc H Tran, Jane Loman, Joseph CaprioliAbstract:Purpose To evaluate the long-term efficacy of intraocular pressure (IOP) reduction and complications of Ahmed Glaucoma Valve (AGV) implantation (New World Medical, Inc, Rancho Cucamonga, California, USA) in refractory Glaucoma. Design Retrospective cohort study. Methods Retrospective medical records from 64 patients (78 eyes) with refractory Glaucoma who underwent AGV implantation with a minimum of three years of follow-up were reviewed. Data regarding age, gender, race, eye laterality, specific Glaucoma diagnosis, best-corrected visual acuity (BCVA), number of medications, IOP, visual fields, surgical complications, and follow-up interval were collected from all visits and were analyzed. The primary outcome measure was cumulative probability of success defined as IOP of less than 21 mm Hg and of 5 mm Hg or more with a minimum of 15% reduction from baseline IOP, without additional Glaucoma surgery or loss of light perception. Secondary outcomes included IOP and number of medications at three, six, 12, 24, 36, 48, and 60 months after surgery, surgical complications, and final BCVA. Results The cumulative probability of success was 80% and 49% at one and five years, respectively. IOP was reduced from a mean of 30.4 ± 10.7 mm Hg to 17.0 ± 5.0 mm Hg at 12 months and 15.9 ± 3.0 mm Hg at 60 months ( P P P Conclusions Approximately 50% of single-plate AGV implantations in refractory Glaucoma were considered successful after five years of follow-up. Prior Glaucoma surgery was a statistically significant risk factor for failure.
Vital Paulino Costa - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of intravitreal bevacizumab in eyes with neovascular Glaucoma undergoing ahmed Glaucoma Valve implantation 2 year follow up
Acta Ophthalmologica, 2015Co-Authors: E S Arcieri, Jayter Silva Paula, Rodrigo Jorge, Kleyton A Barella, Rafael S Arcieri, Danilo J Secches, Vital Paulino CostaAbstract:Purpose To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) in eyes with neovascular Glaucoma (NVG) undergoing Ahmed Glaucoma Valve (AGV) implantation. Methods This was a multicentre, prospective, randomized clinical trial that enrolled 40 patients with uncontrolled neovascular Glaucoma that had undergone panretinal photocoagulation and required Glaucoma drainage device implantation. Patients were randomized to receive IVB (1.25 mg) or not during Ahmed Valve implant surgery. Injections were administered intra-operatively, and 4 and 8 weeks after surgery. Results After a mean follow-up of 2.25 ± 0.67 years (range 1.5–3 years), both groups showed a significant decrease in IOP (p < 0.05). There was no difference in IOP between groups except at the 18-month interval, when IOP in IVB group was significantly lower (14.57 ± 1.72 mmHg vs. 18.37 ± 1.06 mmHg – p = 0.0002). There was no difference in survival success rates between groups. At 24 months, there was a trend to patients treated with IVB using less antiGlaucoma medications than the control group (p = 0.0648). Complete regression of rubeosis iridis was significantly more frequent in the IVB group (80%) than in the control group (25%) (p = 0.0015). Conclusions Intravitreal bevacizumab may lead to regression of new vessels both in the iris and in the anterior chamber angle in patients with neovascular Glaucoma undergoing Ahmed Glaucoma Valve implantation. There is a trend to slightly lower IOPs and number of medications with IVB use during AGV implantation for neovascular Glaucoma.
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efficacy and safety of adjunctive mitomycin c during ahmed Glaucoma Valve implantation a prospective randomized clinical trial
Ophthalmology, 2004Co-Authors: Peter A Netland, Vital Paulino Costa, Augusto Azuarablanco, Mark R Lesk, E S ArcieriAbstract:Abstract Purpose To evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in eyes undergoing Ahmed Glaucoma Valve implantation. Design Randomized controlled clinical trial. Participants Sixty patients with refractory Glaucoma. Intervention Sixty eyes of 60 patients with refractory Glaucoma were randomized to receive intraoperative MMC (0.5 mg/ml for 5 minutes) (n = 34) or balanced salt solution (n = 26) during Ahmed Glaucoma Valve implantation. Main outcome measures Surgical success was defined according to 2 different criteria: (1) postoperative intraocular pressure (IOP) between 6 and 21 mmHg, with or without antiGlaucoma medications, and (2) IOP reduction of at least 30% relative to preoperative values. Eyes requiring additional Glaucoma surgery, developing phthisis, or showing loss of light perception were classified as failures. Success rates in both groups were compared using Kaplan–Meier survival curves and the log rank test. Other outcome measures were mean IOP, number of Glaucoma medications, and complications. Results After a mean follow-up of 12.3 months, Kaplan–Meier survival analysis showed a probability of success of 59% at 18 months for the MMC group and 61% for the control group when the first criterion for success was used (IOP between 6 and 21 mmHg). When an IOP reduction of at least 30% was used as the criterion to define success, the Kaplan–Meier survival analysis demonstrated a probability of success at 18 months of 62% for the MMC group and 67% for the control group. There were no significant differences in survival rates between the 2 groups with either criterion ( P = 0.75 and P = 0.37, respectively). After 15 days postoperatively, the mean IOP did not significantly differ for both MMC and control eyes. Mean numbers of postoperative antiGlaucoma medications were similar in MMC-treated eyes and controls. There was no significant difference between the incidences of postoperative complications in both groups. Conclusion Mitomycin C did not increase the short- or intermediate-term success rates of Ahmed Glaucoma Valve implantation.
Joseph Caprioli - One of the best experts on this subject based on the ideXlab platform.
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strabismus after ahmed Glaucoma Valve implantation
American Journal of Ophthalmology, 2021Co-Authors: Laura Robbins, Anne L Coleman, Kouros Nourimahdavi, Toshiaki Goseki, Simon Law, Joseph Caprioli, Joann A Giaconi, Joseph L Demer, Federico G Velez, Stacy L PinelesAbstract:Purpose Most reports of strabismus after Glaucoma drainage device implantation study larger devices and rarely note the incidence of strabismus after Ahmed Glaucoma Valve (AGV) implantation. It is unknown if the pattern of strabismus is similar with smaller devices. We investigated characteristics of strabismus after AGV implantation. Design Retrospective review. Methods Institutional study of 732 patients at our institution undergoing AGV implantation between 2013 and 2018. Rate and characteristics of strabismus were the primary outcome; age, gender, and location of AGVs were also analyzed. Results We identified 29 patients who developed new-onset strabismus postoperatively after initial AGV implantation, for 4% incidence of strabismus. Twenty-one (72%) of these had diplopia. AGVs were implanted superotemporally in 21, superonasally in 5, inferotemporally in 1, and inferonasally in 2. Three patients were esotropic, 11 were exotropic, 4 had hypertropia, 2 had hypotropia, and 9 patients had combined horizontal/vertical strabismus (esotropia/hypotropia [n = 1] or exotropia/hypertropias [n = 8]). Exotropia was the most common type of strabismus in both the superotemporal and superonasal (60%) AGV groups. Superotemporal AGVs were more commonly associated with ipsilateral hypertropia (43%) than superonasal AGVs. Treatments included strabismus surgery (n = 14), prisms (n = 6), or an occlusive lens (n = 1). Discussion. In the largest single-center series of patients undergoing initial AGV implantation, the overall incidence of postoperative strabismus was 4%. This is comparable to strabismus incidence following implantation of other types of Glaucoma drainage devices, even larger devices. The possibility of this complication should be discussed with patients prior to surgery.
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outcomes of ahmed Glaucoma Valve implantation in children with primary congenital Glaucoma
Archives of Ophthalmology, 2009Co-Authors: Simon Law, Anne L Coleman, Joseph CaprioliAbstract:Objectives To evaluate the long-term efficacy of intraocular pressure reduction and complications of Ahmed Glaucoma Valve (AGV) implantation in children with primary congenital Glaucoma. Methods The medical records of patients with primary congenital Glaucoma who underwent AGV implantation with a minimum follow-up of 6 months were reviewed. The primary outcome measure was cumulative probability of success, defined as intraocular pressure greater than 5 mm Hg and less than 23 mm Hg and at least a 15% reduction from the preoperative intraocular pressure, without serious complications, additional Glaucoma surgery, or loss of light perception. Results Thirty eyes of 19 children with primary congenital Glaucoma who underwent AGV implantation with a minimum follow-up of 6 months were reviewed. The children had a mean (SD) age of 1.8 (2.6) years, a mean (SD) preoperative intraocular pressure of 28.4 (6.7) mm Hg, and a mean (SD) follow-up time of 57.6 (48.0) months. The cumulative probability of success was 63% in 1 year and 33% in 5 years. After a second AGV implantation, the cumulative probability of success was 86% in 1 and 2 years and 69% in 5 years. Hispanic ethnicity ( P = .02) and being female ( P = .005) were associated with increased risk of failure. Conclusions Thirty-three percent of AGV implantations in children with primary congenital Glaucoma were successful after 5 years of follow-up. With the implantation of a second AGV, the 5-year success rate increased to 69%.
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dynamic tube movement of ahmed Glaucoma Valve
Journal of Glaucoma, 2009Co-Authors: Simon Law, Anne L Coleman, Joseph CaprioliAbstract:PURPOSE To report the dynamic movement of the tube of the Ahmed Glaucoma Valve (AGV) in the anterior chamber with eye movement. PATIENTS AND METHODS Three patients (eyes) with dynamic movement of the tube of the AGV out of approximately 1500 AGV implantations over 10 years were identified. Demographic information, management, and patient outcomes were abstracted from the medical records. Possible mechanisms of the tube movement are discussed. RESULTS In all 3 eyes, the fibrovascular capsule and the plate were noted to be stationary in the superior temporal fornix under the conjunctiva and did not move with movement of the eye. The length of the intraocular portion of the tube varied between 3 and 4 mm, depending on the position of the globe. All 3 eyes had undergone at least 1 intraocular procedure before AGV implantation and 2 of 3 eyes had at least 1 intraocular procedure after the AGV implantation. The dynamic movement of the tube was first observed from 0.5 to 7 years after the AGVs were implanted. It was not associated with any intraocular reaction, damage of intraocular tissue, or decrease of intraocular pressure control, and no additional surgical intervention has been required. CONCLUSIONS Dynamic movement of the tube of AGV results from dissociation of the fibrovascular capsule and the plate in the fornix from the rotation of the globe. The length of the intraocular portion of the tube may vary widely with eye movement.
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long term outcomes of ahmed Glaucoma Valve implantation in refractory Glaucomas
American Journal of Ophthalmology, 2007Co-Authors: Carlos Souza, Anne L Coleman, Simon Law, Duc H Tran, Jane Loman, Joseph CaprioliAbstract:Purpose To evaluate the long-term efficacy of intraocular pressure (IOP) reduction and complications of Ahmed Glaucoma Valve (AGV) implantation (New World Medical, Inc, Rancho Cucamonga, California, USA) in refractory Glaucoma. Design Retrospective cohort study. Methods Retrospective medical records from 64 patients (78 eyes) with refractory Glaucoma who underwent AGV implantation with a minimum of three years of follow-up were reviewed. Data regarding age, gender, race, eye laterality, specific Glaucoma diagnosis, best-corrected visual acuity (BCVA), number of medications, IOP, visual fields, surgical complications, and follow-up interval were collected from all visits and were analyzed. The primary outcome measure was cumulative probability of success defined as IOP of less than 21 mm Hg and of 5 mm Hg or more with a minimum of 15% reduction from baseline IOP, without additional Glaucoma surgery or loss of light perception. Secondary outcomes included IOP and number of medications at three, six, 12, 24, 36, 48, and 60 months after surgery, surgical complications, and final BCVA. Results The cumulative probability of success was 80% and 49% at one and five years, respectively. IOP was reduced from a mean of 30.4 ± 10.7 mm Hg to 17.0 ± 5.0 mm Hg at 12 months and 15.9 ± 3.0 mm Hg at 60 months ( P P P Conclusions Approximately 50% of single-plate AGV implantations in refractory Glaucoma were considered successful after five years of follow-up. Prior Glaucoma surgery was a statistically significant risk factor for failure.
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evaluation of the hypertensive phase after insertion of the ahmed Glaucoma Valve
American Journal of Ophthalmology, 2003Co-Authors: Kouros Nourimahdavi, Joseph CaprioliAbstract:Abstract Purpose To investigate the postoperative hypertensive phase (HP) in patients undergoing Glaucoma drainage implant surgery. Design Interventional case series. Methods A retrospective chart review of 156 consecutive eyes (139 patients) who underwent placement of an Ahmed Glaucoma Valve (AGV) with a follow-up of ≥3 months was performed. Main outcome measures were occurrence and resolution of the HP and intraocular pressure (IOP) control. The HP was defined as IOP > 21 mm Hg during the first 3 months after surgery. Resolution of the HP was defined as an IOP Results An HP was observed in 88 eyes (56%). It occurred after a mean of 5.0 weeks (median, 4 weeks; range, 1–13 weeks) with an average (± standard deviation) peak IOP of 30.1 (± 7.5) mm Hg. Resolution of the HP occurred in 19 of 68 eyes (28%) with available data. Eyes with an HP had a higher mean IOP and needed more medications 6 to 12 months after surgery than eyes without an HP (17.2 ± 5.6 vs 14.3 ± 5.8 mm Hg; P = .012 and 1.7 ± 1.2 vs 0.3 ± 0.6 medications; P Conclusion A hypertensive phase occurs frequently after implantation of the AGV. However, it resolves in only a minority of eyes. The majority of eyes with an HP have no significant improvement of IOP control and continue to require the same number of Glaucoma medications as they did during the HP.
Luciano Quaranta - One of the best experts on this subject based on the ideXlab platform.
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A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations
Advances in Therapy, 2017Co-Authors: Ivano Riva, Gloria Roberti, Francesco Oddone, Andreas Katsanos, Luciano QuarantaAbstract:The Ahmed Glaucoma Valve (AGV) is a popular Glaucoma drainage implant used for the control of intraocular pressure in patients with Glaucoma. While in the past AGV implantation was reserved for Glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory Glaucoma. Compared to other Glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with Glaucoma.
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ahmed Glaucoma Valve implant surgical technique and complications
Clinical Ophthalmology, 2017Co-Authors: Ivano Riva, Gloria Roberti, Francesco Oddone, Anastasios G P Konstas, Luciano QuarantaAbstract:Implantation of Ahmed Glaucoma Valve is an effective surgical technique to reduce intraocular pressure in patients affected with Glaucoma. While in the past, the use of this device was reserved to Glaucoma refractory to multiple filtration surgical procedures, up-to-date mounting experience has encouraged its use also as a primary surgery for selected cases. Implantation of Ahmed Glaucoma Valve can be challenging for the surgeon, especially in patients who already underwent previous multiple surgeries. Several tips have to be acquired by the surgeon, and a long learning curve is always needed. Although the Valve mechanism embedded in the Ahmed Glaucoma Valve decreases the risk of postoperative hypotony-related complications, it does not avoid the need of a careful follow-up. Complications related to this type of surgery include early and late postoperative hypotony, excessive capsule fibrosis around the plate, erosion of the tube or plate edge, and very rarely infection. The aim of this review is to describe surgical technique for Ahmed Glaucoma Valve implantation and to report related complications.
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needle revision with 5 fluorouracil for the treatment of ahmed Glaucoma Valve filtering blebs 5 fluoruracil needling revision can be a useful and safe tool in the management of failing ahmed Glaucoma Valve filtering blebs
Journal of Glaucoma, 2016Co-Authors: Luciano Quaranta, Irene Floriani, Lital Hollander, Davide Poli, Andreas Katsanos, Anastasios G P KonstasAbstract:Purpose:To determine the outcome of needling with adjunctive 5-fluorouracil (5-FU) in patients with a failing Ahmed Glaucoma Valve (AGV) implant, and to identify predictors of long-term intraocular pressure (IOP) control.Methods:A prospective observational study was performed on consecutive patients
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outcomes of using a sutureless bovine pericardial patch graft for ahmed Glaucoma Valve implantation
European Journal of Ophthalmology, 2013Co-Authors: Luciano Quaranta, Ivano Riva, Irene FlorianiAbstract:PurposeTo evaluate the long-term outcomes of a surgical technique using a sutureless bovine pericardial patch graft for the implantation of an Ahmed Glaucoma Valve (AGV).MethodsThis was a pilot stu...