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Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus: short-term results

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Abstract

Purpose

To evaluate the clinical outcomes of pseudophakic/aphakic eyes with uncontrolled glaucoma that underwent Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus.

Methods

Medical records of the patients who underwent Ahmed glaucoma valve implantation through the ciliary sulcus, between December 2017 and June 2019, were reviewed retrospectively. Patients’ age, gender, glaucoma diagnosis, visual acuity, intraocular pressure levels, and complications were recorded.

Results

Forty-seven eyes of 43 patients with glaucoma were enrolled. The mean age was 54.5 ± 19.9 years (range, 7–88 years) at the time of surgery, and the mean postoperative follow-up period was 7.9 ± 3.4 months (range, 3–16 months). The mean preoperative intraocular pressure level was 35.2 ± 6.8 mmHg (range, 25–55 mmHg), and it was found as 15.6 ± 5.4 mmHg (range, 9–33 mmHg) at the last follow-up visit. Decrease in intraocular pressure level was statistically significant (P < 0.001). At the last follow-up visit, success (postoperative IOP ≥ 6 mmHg and ≤ 21 mmHg with or without antiglaucomatous medications, without further surgery for IOP control, without loss of light perception and without removal of the implant) was achieved in 41 eyes (87.2%). Hyphema was the most common postoperative complication and developed in 11 eyes (23.4%) and resolved spontaneously in all of them within one month.

Conclusion

In pseudophakic or aphakic eyes with uncontrolled glaucoma, placement of Ahmed glaucoma valve tube in the ciliary sulcus is a safe and effective procedure. Ciliary sulcus can be considered as a potential space during tube shunt surgery in eyes with high risk of tube–corneal touch or corneal decompensation.

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Data availability

Data used in this study are available upon requests.

References

  1. Patel S, Pasquale LR (2010) Glaucoma drainage devices: a review of the past, present, and future. Semin Ophthalmol 25:265–270. https://doi.org/10.3109/08820538.2010.518840

    Article  PubMed  Google Scholar 

  2. Swaminathan SS, Gedde SJ (2018) Evolving indications for tube shunt surgery. Int Ophthalmol Clin 58:135–144. https://doi.org/10.1097/IIO.0000000000000226

    Article  PubMed  Google Scholar 

  3. Koo EB, Hou J, Keenan JD, Stamper RL, Jeng BH, Han Y (2016) Effect of glaucoma tube surgery on corneal endothelial cells: a review. Eye Contact Lens 42:221–224. https://doi.org/10.1097/ICL.0000000000000171

    Article  PubMed  Google Scholar 

  4. Kim CS, Yim JH, Lee EK, Lee NH (2008) Changes in corneal endothelial cell density and morphology after Ahmed glaucoma valve implantation during the first year of follow up. Clin Exp Ophthalmol 36:142–147. https://doi.org/10.1111/j.1442-9071.2008.01683.x

    Article  PubMed  Google Scholar 

  5. Hollander DA, Giaconi JA, Holland GN, Yu F, Caprioli J, Aldave AJ, Coleman AL, Casey R, Law SK, Mondino BJ (2010) Graft failure after penetrating keratoplasty in eyes with Ahmed valves. Am J Ophthalmol 150:169–178. https://doi.org/10.1016/j.ajo.2010.02.014

    Article  PubMed  Google Scholar 

  6. Arroyave CP, Scott IU, Fantes FE, Feuer WJ, Murray TG (2001) Corneal graft survival and intraocular pressure control after penetrating keratoplasty and glaucoma drainage device implantation. Ophthalmology 108:1978–1985. https://doi.org/10.1016/s0161-6420(01)00803-x

    Article  CAS  PubMed  Google Scholar 

  7. Kaynak S, Tekin NF, Durak I, Berk AT, Saatci AO, Soylev MF (1998) Pars plana vitrectomy with pars plana tube implantation in eyes with intractable glaucoma. Br J Ophthalmol 82:1377–1382. https://doi.org/10.1136/bjo.82.12.1377

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Schlote T, Ziemssen F, Bartz-Schmidt KU (2006) Pars plana-modified Ahmed glaucoma valve for treatment of refractory glaucoma: a pilot study. Graefes Arch Clin Exp Ophthalmol 244:336–341. https://doi.org/10.1007/s00417-005-0008-5

    Article  PubMed  Google Scholar 

  9. Lloyd MA, Heuer DK, Baerveldt G, Minckler DS, Martone JF, Lean JS, Liggett PE (1991) Combined Molteno implantation and pars plana vitrectomy for neovascular glaucomas. Ophthalmology 98:1401–1405. https://doi.org/10.1016/s0161-6420(91)32120-1

    Article  CAS  PubMed  Google Scholar 

  10. Maris PJ Jr, Tsai JC, Khatib N, Bansal R, Al-Aswad LA (2013) Clinical outcomes of Ahmed glaucoma valve in posterior segment versus anterior chamber. J Glaucoma 22:183–189. https://doi.org/10.1097/IJG.0b013e318237c115

    Article  PubMed  Google Scholar 

  11. Rumelt S, Rehany U (1998) Implantation of glaucoma drainage implant tube into the ciliary sulcus in patients with corneal transplants. Arch Ophthalmol 116:685–687. https://doi.org/10.1001/archopht.116.5.685

    Article  CAS  PubMed  Google Scholar 

  12. Tello C, Espana E, Mora R, Dorairaj S, Liebmann JM, Ritch R (2007) Baerveldt glaucoma implant insertion in the posterior chamber sulcus. Br J Ophthalmol 91:739–742. https://doi.org/10.1136/bjo.2006.107839

    Article  PubMed  PubMed Central  Google Scholar 

  13. Weiner A, Cohn AD, Balasubramaniam M, Weiner AJ (2010) Glaucoma tube shunt implantation through the ciliary sulcus in pseudophakic eyes with high risk of corneal decompensation. J Glaucoma 19:405–411. https://doi.org/10.1097/IJG.0b013e3181bdb52d

    Article  PubMed  Google Scholar 

  14. Eslami Y, Mohammadi M, Fakhraie G, Zarei R, Moghimi S (2014) Ahmed glaucoma valve implantation with tube insertion through the ciliary sulcus in pseudophakic/aphakic eyes. J Glaucoma 23:115–118. https://doi.org/10.1097/IJG.0b013e318265bc0b

    Article  PubMed  Google Scholar 

  15. Rush R (2009) Ciliary sulcus Ahmed glaucoma valve tube placement in neovascular glaucoma. Ophthalmic Surg Lasers Imaging 40:489–492. https://doi.org/10.3928/15428877-20090901-08

    Article  PubMed  Google Scholar 

  16. Moon K, Kim YC, Kim KS (2007) Ciliary sulcus Ahmed valve implantation. Korean J Ophthalmol 21:127–130. https://doi.org/10.3341/kjo.2007.21.2.127

    Article  PubMed  PubMed Central  Google Scholar 

  17. Prata TS, Mehta A, De Moraes CG, Tello C, Liebmann J, Ritch R (2010) Baerveldt glaucoma implant in the ciliary sulcus: midterm follow-up. J Glaucoma 19:15–18. https://doi.org/10.1097/IJG.0b013e3181a2fc2d

    Article  PubMed  Google Scholar 

  18. Bayer A, Onol M (2017) Clinical outcomes of Ahmed glaucoma valve in anterior chamber versus ciliary sulcus. Eye 31:608–614. https://doi.org/10.1038/eye.2016.273

    Article  CAS  PubMed  Google Scholar 

  19. Asaoka S, Kasuga T, Matsunaga T, Hayashi Y, Asada Y, Iwamoto S, Hirakata T, Honda R, Obazawa H, Sasaki H, Ohta T, Matsuda A (2021) Operative complications of glaucoma drainage implant tube insertion through the sulcus for pseudophakic eye. J Glaucoma 30:e169–e174. https://doi.org/10.1097/IJG.0000000000001783

    Article  PubMed  Google Scholar 

  20. Lee EK, Yun YJ, Lee JE, Yim JH, Kim CS (2009) Changes in corneal endothelial cells after Ahmed glaucoma valve implantation: 2-year follow-up. Am J Ophthalmol 148:361–367. https://doi.org/10.1016/j.ajo.2009.04.016

    Article  PubMed  Google Scholar 

  21. Topouzis F, Coleman AL, Choplin N, Bethlem MM, Hill R, Yu F, Panek WC, Wilson MR (1999) Follow-up of the original cohort with the Ahmed glaucoma valve implant. Am J Ophthalmol 128:198–204. https://doi.org/10.1016/s0002-9394(99)00080-x

    Article  CAS  PubMed  Google Scholar 

  22. Budenz DL, Feuer WJ, Barton K, Schiffman J, Costa VP, Godfrey DG, Buys YM, Ahmed Baerveldt Comparison Study Group (2016) Postoperative complications in the Ahmed Baerveldt comparison study during five years of follow-up. Am J Ophthalmol 163:75–82. https://doi.org/10.1016/j.ajo.2015.11.023

    Article  PubMed  Google Scholar 

  23. Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC, Tube Versus Trabeculectomy Study Group (2012) Postoperative complications in the tube versus trabeculectomy (TVT) study during five years of follow-up. Am J Ophthalmol 153:804–814. https://doi.org/10.1016/j.ajo.2011.10.024

    Article  PubMed  PubMed Central  Google Scholar 

  24. Mills RP, Reynolds A, Emond MJ, Barlow WE, Leen MM (1996) Long-term survival of molteno glaucoma drainage devices. Ophthalmology 103:299–305. https://doi.org/10.1016/s0161-6420(96)30700-8

    Article  CAS  PubMed  Google Scholar 

  25. Koo EB, Hou J, Han Y, Kenan JD, Stamper RL, Jeng BH (2015) Effect of glaucoma tube shunt parameters on cornea endothelial cells in patients with Ahmed valve implants. Cornea 34:37–41. https://doi.org/10.1097/ICO.0000000000000301

    Article  PubMed  Google Scholar 

  26. Jiang C, Li Y, Huang D, Francis BA (2012) Study of anterior chamber aqueous tube shunt by fourier-domain optical coherence tomography. J Ophthalmol 2012:189580. https://doi.org/10.1155/2012/189580

    Article  PubMed  PubMed Central  Google Scholar 

  27. Zhang Q, Liu Y, Thanapaisal S, Oatts J, Luo Y, Ying GS, Wang J, McLeod SD, Gedde SJ, Han Y (2021) The effect of tube location on corneal endothelial cells in patients with Ahmed glaucoma valve. Ophthalmology 128:218–226. https://doi.org/10.1016/j.ophtha.2020.06.050

    Article  PubMed  Google Scholar 

  28. Alobaida IA, Malik R, Ahmad S (2020) Comparison of surgical outcomes between sulcus and anterior chamber implanted glaucoma drainage devices. Saudi J Ophthalmol 34:1–7. https://doi.org/10.4103/1319-4534.301298

    Article  PubMed  PubMed Central  Google Scholar 

  29. Hau S, Scott A, Bunce C, Barton K (2011) Corneal endothelial morphology in eyes implanted with anterior chamber aqueous shunts. Cornea 30:50–55. https://doi.org/10.1097/ICO.0b013e3181e16d7d

    Article  PubMed  Google Scholar 

  30. Desatnik HR, Foster RE, Rockwood EJ, Baerveldt G, Meyers SM, Lewis H (2000) Management of glaucoma implants occluded by vitreous incarceration. J Glaucoma 9:311–316. https://doi.org/10.1097/00061198-200008000-00005

    Article  CAS  PubMed  Google Scholar 

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Dokuz Eylul University School of Medicine, 35340, Izmir, Turkey

    Gul Arikan, Betul Akbulut, Canan Asli Utine, Ziya Ayhan, Mahmut Kaya, Taylan Ozturk & Uzeyir Gunenc

Authors
  1. Gul Arikan
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  2. Betul Akbulut
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  3. Canan Asli Utine
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  4. Ziya Ayhan
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  5. Mahmut Kaya
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  6. Taylan Ozturk
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  7. Uzeyir Gunenc
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Gul Arikan, Betul Akbulut, Canan Asli Utine, Ziya Ayhan, Mahmut Kaya, Taylan Ozturk, and Uzeyir Gunenc. The first draft of the manuscript was written by Gul Arikan and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gul Arikan.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Consent for publication

Nonapplicable due to the retrospective design.

Ethical approval

Approval was obtained from the ethics committee of Dokuz Eylul University. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Informed Consent

Nonapplicable due to the retrospective design.

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Arikan, G., Akbulut, B., Utine, C.A. et al. Ahmed glaucoma valve implantation with the tube placement in the ciliary sulcus: short-term results. Int Ophthalmol 42, 969–980 (2022). https://doi.org/10.1007/s10792-021-02080-w

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  • DOI: https://doi.org/10.1007/s10792-021-02080-w

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