International Ophthalmology

, Volume 38, Issue 5, pp 1833–1838 | Cite as

Outcomes of Ahmed glaucoma valve implantation for steroid-induced elevated intraocular pressure in patients with retinitis pigmentosa

  • Umit Eksioglu
  • Caglar Oktem
  • Gulten Sungur
  • Mehmet YakinEmail author
  • Gulizar Demirok
  • Firdevs Ornek
Original Paper



To evaluate the outcomes of Ahmed glaucoma valve (AGV) in the management of elevated intraocular pressure (IOP) secondary to steroid use for macular edema in patients with retinitis pigmentosa (RP).


A total of nine eyes of five patients were evaluated retrospectively. Complete success was defined as IOP ≤ 21 mmHg without glaucoma medications, while qualified success was defined as IOP ≤ 21 mmHg with glaucoma medications.


Mean age at surgery was 25.0 ± 8.3 years, and mean follow-up time was 38.4 ± 13.2 months. Mean IOP was 41.0 ± 8.3 mmHg preoperatively, 9.4 ± 3.5 mmHg at first week (p = 0.008), 13.1 ± 3.6 mmHg at first month (p = 0.008), 14.8 ± 4.1 mmHg at 6th month (p = 0.008), 11.7 ± 2.6 mmHg at 12th month (p = 0.008), 12.4 ± 2.9 mmHg at 24th month (p = 0.008), 12.6 ± 3.6 mmHg at 36th month (p = 0.043) and 12.8 ± 4.2 mmHg at 48th month (p = 0.068) postoperatively. The mean number of topical anti-glaucomatous medications decreased from 2.8 ± 0.4 preoperatively to 0.4 ± 0.9 postoperatively (p = 0.007). Complete success was obtained in 7 (77%) eyes, and qualified success in 2 (23%) eyes. No failure was detected.


AGV implantation can be considered as an alternative and safe option in the management of resistant, elevated IOP secondary to steroid treatment for macular edema in patients with RP.


Retinitis pigmentosa Macular edema Steroid-induced intraocular pressure elevation Ahmed glaucoma valve 



The corresponding author Dr. Mehmet Yakin has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis as well as the decision to submit for publication.


The study received no funding support from any institution or organization.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the institutional review board of the hospital. Before surgeries and other invasive procedures, written informed consent was obtained from all patients.


  1. 1.
    Hamel C (2006) Retinitis pigmentosa. Orphanet J Rare Dis 1:40. doi: 10.1186/1750-1172-1-40 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Baumgartner WA (2000) Etiology, pathogenesis, and experimental treatment of retinitis pigmentosa. Med Hypotheses 54:814–824. doi: 10.1054/mehy.1999.0957 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Salvatore S, Fishman GA, Genead MA (2013) Treatment of cystic macular lesions in hereditary retinal dystrophies. Surv Ophthalmol 58:560–584. doi: 10.1016/j.survophthal.2012.11.006 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Sahel J, Bonnel S, Mrejen S, Paques M (2010) Retinitis pigmentosa and other dystrophies. Dev Ophthalmol 47:160–167. doi: 10.1159/000320079 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Saatci AO, Selver OB, Seymenoglu G, Yaman A (2013) Bilateral intravitreal dexamethasone implant for retinitis pigmentosa-related macular edema. Case Rep Ophthalmol 4:53–58. doi: 10.1159/000350544 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Razeghinejad MR, Katz LJ (2012) Steroid-induced iatrogenic glaucoma. Ophthalmic Res 47:66–80. doi: 10.1159/000328630 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Clark AF, Wordinger RJ (2009) The role of steroids in outflow resistance. Exp Eye Res 88:752–759. doi: 10.1016/j.exer.2008.10.004 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Iwao K, Inatani M, Kawaji T, Koga T, Mawatari Y, Tanihara H (2007) Frequency and risk factors for intraocular pressure elevation after posterior sub-Tenon capsule triamcinolone acetonide injection. J Glaucoma 16:251–256. doi: 10.1097/IJG.0b013e31802d696f CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kiddee W, Trope GE, Sheng L, Beltran-Agullo L, Smith M, Strungaru MH, Baath J, Buys YM (2013) Intraocular pressure monitoring post intravitreal steroids: a systematic review. Surv Ophthalmol 58:291–310. doi: 10.1016/j.survophthal.2012.08.003 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    HaiBo T, Xin K, ShiHeng L, Lin L (2015) Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis. PLoS ONE 10:e0118142. doi: 10.1371/journal.pone.0118142 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Bikbov MM, Khusnitdinov II (2015) The results of the use of Ahmed valve in refractory glaucoma surgery. J Curr Glaucoma Pract 9:86–91. doi: 10.5005/jp-journals-10008-1191 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Singh IP, Ahmad SI, Yeh D, Challa P, Herndon LW, Allingham RR, Lee PP (2004) Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection. Am J Ophthalmol 138:286–287. doi: 10.1016/j.ajo.2004.03.001 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Rubin B, Taglienti A, Rothman RF, Marcus CH, Serle JB (2008) The effect of selective laser trabeculoplasty on intraocular pressure in patients with intravitreal steroid-induced elevated intraocular pressure. J Glaucoma 17:287–292. doi: 10.1097/IJG.0b013e318031676c CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Malone PE, Herndon LW, Muir KW, Jaffe GJ (2010) Combined fluocinolone acetonide intravitreal insertion and glaucoma drainage device placement for chronic uveitis and glaucoma. Am J Ophthalmol 149:800–806. doi: 10.1016/j.ajo.2009.12.009 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Department of OphthalmologyAnkara Training and Research HospitalAltindagTurkey
  2. 2.Manavgat State HospitalManavgatTurkey

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