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Tenon advancement and duplication technique to prevent postoperative Ahmed valve tube exposure in patients with refractory glaucoma

  • Clinical Investigation
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Abstract

Purpose

To present and compare the long-term results of Dr. Tamcelik’s previously described technique of Tenon advancement and duplication with the conventional Ahmed glaucoma valve (AGV) implantation technique in patients with refractory glaucoma.

Methods

This study was a multicenter, retrospective case series that included 303 eyes of 276 patients with refractory glaucoma who underwent glaucoma valve implantation surgery. The patients were divided into three groups according to the surgical technique applied and the outcomes compared. In group 1, 96 eyes of 86 patients underwent AGV implant surgery without patch graft; in group 2, 78 eyes of 72 patients underwent AGV implant surgery with donor scleral patch; in group 3, 129 eyes of 118 patients underwent Ahmed valve implant surgery with “combined short scleral tunnel with Tenon advancement and duplication technique”. The endpoint assessed was tube exposure through the conjunctiva.

Results

In group 1, conjunctival tube exposure was seen in 11 eyes (12.9 %) after a mean 9.2 ± 3.7 years of follow-up. In group 2, conjunctival tube exposure was seen in six eyes (2.2 %) after a mean 8.9 ± 3.3 years of follow-up. In group 3, there was no conjunctival exposure after a mean 7.8 ± 2.8 years of follow-up. The difference between the groups was statistically significant. (P = 0.0001, Chi-square test).

Conclusion

This novel surgical technique combining a short scleral tunnel with Tenon advancement and duplication was found to be effective and safe to prevent conjunctival tube exposure after AGV implantation surgery in patients with refractory glaucoma.

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References

  1. Syed HM, Law SK, Nam SH, Li G, Caprioli J, Coleman A. Baerveldt-350 implant versus Ahmed valve for refractory glaucoma: a case-controlled comparison. J Glaucoma. 2004;13:38–45.

    Article  PubMed  Google Scholar 

  2. Al-Mobarak F, Khan AO. Complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life. Br J Ophthalmol. 2009;93:795–8.

    Article  PubMed  CAS  Google Scholar 

  3. Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC. Surgical complications in the Tube Versus Trabeculectomy Study during the first year of follow-up. Am J Ophthalmol. 2007;143:23–31.

    Article  PubMed  Google Scholar 

  4. Sarkisian SR Jr. Tube shunt complications and their prevention. Curr Opin Ophthalmol. 2009;20:126–30.

    Article  PubMed  Google Scholar 

  5. Freedman J. Scleral patch grafts with Molteno setons. Ophthalmic Surg. 1987;18:532–4.

    PubMed  CAS  Google Scholar 

  6. Brandt JD. Patch grafts of dehydrated cadaveric dura mater for tube-shunt glaucoma surgery. Arch Ophthalmol. 1993;111:1436–9.

    Article  PubMed  CAS  Google Scholar 

  7. Smith MF, Doyle JW, Ticrney JW Jr. A comparison of glaucoma drainage implant tube coverage. J Glaucoma. 2002;11:143–7.

    Article  PubMed  Google Scholar 

  8. Kurnaz E, Kubaloğlu A, Aşık N, Özdemir B, Erol K, Özertürk Y. Lamellar donor cornea in Ahmed glaucoma valve surgery. Turk J Ophthalmol. 2009;39:103–10.

    Google Scholar 

  9. Tamcelik N, Sarici AM, Yetik H, Ozkok A, Ozkiris A. A novel surgical technique to prevent postoperative Ahmed valve tube exposure through conjunctiva: Tenon advancement and duplication. Ophthalmic Surg Lasers Imaging. 2010;41:370–4.

    Article  PubMed  Google Scholar 

  10. Hijikata K, Masuda K. Visual prognosis in Behcet’s disease: effects of cyclophosphamide and colchicine. Jpn J Ophthalmol. 1978;22:506–19.

    Google Scholar 

  11. Tamcelik N, Ozkiris A, Sarici AM. Long-term results of combined viscotrabeculotomy-trabeculectomy in refractory developmental glaucoma. Eye (Lond). 2010;24:613–8.

    Article  CAS  Google Scholar 

  12. Tamçelik N, Ozkiriş A. A comparison of viscogoniotomy with classical goniotomy in Turkish patients. Jpn J Ophthalmol. 2004;48:404–7.

    Article  PubMed  Google Scholar 

  13. Aktas S, Cilsim S, Aktas H, Eltutar K. Comparison of clinical results between silicone and polypropylene Ahmed glaucoma valves in end-stage glaucoma. Turk J Ophthalmol. 2008;38:381–8.

    Google Scholar 

  14. Gutierrez-Diaz E, Montero-Rodriguez M, Mencia-Gutierrez E, Fernandez-Gonzalez MC, Perez-Blazquez E. Propionibacterium acnes endophthalmitis in Ahmed glaucoma valve. Eur J Ophthalmol. 2001;11:383–5.

    PubMed  CAS  Google Scholar 

  15. del-Hierro-Zarzuelo A, Vico-Ruiz E, Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo-Martin A, Garcia-Sanchez J. Late endophthalmitis following Ahmed valve (in Spanish). Arch Soc Esp Oftalmol. 2005;80:659–61.

    Article  PubMed  CAS  Google Scholar 

  16. Melamed S, Fiore PM. Molteno implant surgery in refractory glaucoma. Surv Ophthalmol. 1990;34:441–8.

    Article  PubMed  CAS  Google Scholar 

  17. Tanji TM, Lundy DC, Minckler DS, Heuer DK, Varma R. Fascia lata patch graft in glaucoma tube surgery. Ophthalmology. 1996;103:1309–12.

    PubMed  CAS  Google Scholar 

  18. Raviv T, Greenfield DS, Liebmann JM, Sidoti PA, Ishikawa H, Ritch R. Pericardial patch grafts in glaucoma implant surgery. J Glaucoma. 1998;7:27–32.

    Article  PubMed  CAS  Google Scholar 

  19. Byun YS, Lee NY, Park CK. Risk factors of implant exposure outside the conjunctiva after Ahmed glaucoma valve implantation. Jpn J Ophthalmol. 2009;53:114–9.

    Article  PubMed  Google Scholar 

  20. Melamed S, Cahane M, Gutman I, Blumenthal M. Postoperative complications after Molteno implant surgery. Am J Ophthalmol. 1991;111:319–22.

    PubMed  CAS  Google Scholar 

  21. Mills RP, Reynolds A, Emond MJ, Barlow WE, Leen MM. Long-term survival of Molteno glaucoma drainage devices. Ophthalmology. 1996;103:299–305.

    PubMed  CAS  Google Scholar 

  22. Morad Y, Donaldson CE, Kim YM, Abdolell M, Levin AV. The Ahmed drainage implant in the treatment of pediatric glaucoma. Am J Ophthalmol. 2003;135:821–9.

    Article  PubMed  Google Scholar 

  23. Leuenberger E, Rivera J, Veloso M. Ahmed glaucoma valve tube erosion: a retrospective comparative review of autologous scleral patch versus donor scleral patch grafts. Asian J Ophthalmol. 2008;10:347–53.

    Google Scholar 

  24. Ozdamar A, Aras C, Ustundag C, Tamcelik N, Ozkan S. Scleral tunnel for the implantation of glaucoma Seton devices. Ophthalmic Surg Lasers. 2001;32:432–5.

    PubMed  CAS  Google Scholar 

  25. Ollila M, Falck A, Airaksinen PJ. Placing the Molteno implant in a long scleral tunnel to prevent postoperative tube exposure. Acta Ophthalmol Scand. 2005;83:302–5.

    Article  PubMed  Google Scholar 

  26. Lusky M, Weinreb RN. Preservation of scleral grafts to avoid HIV infection. J Glaucoma. 1992;1:221.

    Article  PubMed  CAS  Google Scholar 

  27. Centers for Disease Control. Creutzfeldt–Jacob disease associated with cadaveric dura mater grafts. MMWR. 1997;46:1066–9.

    Google Scholar 

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Authors and Affiliations

  1. Ophthalmology Department, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey

    Nevbahar Tamcelik, Ahmet Ozkok, Ahmet Murat Sarıcı, Eray Atalay & Huseyin Yetik

  2. Ophthalmology Department, Gaziantep School of Medicine, Gaziantep University, Gaziantep, Turkey

    Kivanc Gungor

  3. Goz Hastaliklari Anabilim Dali, Cerrahpasa Tip Fakultesi, Istanbul Universitesi, Kocamustafapasa, Istanbul, Turkey

    Nevbahar Tamcelik

Authors
  1. Nevbahar Tamcelik
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  2. Ahmet Ozkok
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  3. Ahmet Murat Sarıcı
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  4. Eray Atalay
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  5. Huseyin Yetik
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  6. Kivanc Gungor
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Corresponding author

Correspondence to Nevbahar Tamcelik.

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Tamcelik, N., Ozkok, A., Sarıcı, A.M. et al. Tenon advancement and duplication technique to prevent postoperative Ahmed valve tube exposure in patients with refractory glaucoma. Jpn J Ophthalmol 57, 359–364 (2013). https://doi.org/10.1007/s10384-013-0249-5

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  • DOI: https://doi.org/10.1007/s10384-013-0249-5

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