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Preservation of corneal endothelium after pars plana tube insertion of the Ahmed glaucoma valve

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate surgical outcomes after pars plana implantation of the Ahmed glaucoma valve (ppAGV).

Methods

The intraocular pressure, corneal endothelial damage and post-surgical complications of 31 consecutive refractory glaucoma eyes of 26 subjects who underwent ppAGV were prospectively studied at two centers.

Results

Cell density (CD) at the central cornea decreased by 3.5 ± 15.0 and 10.2 ± 18.9% at 6 and 12 months, respectively. The CD loss at 1 year was comparable with the loss after cataract surgery alone (6.5 ± 8.5%, P = 0.441). Hexagonality (Hex) changed little, from 41.5 ± 15.6% at baseline to 41.8 ± 14.9% (P = 0.976) at 6 months and 41.6 ± 10.2% (P = 0.58) at 12 months. The coefficient of variation of the central corneal endothelium area (CV) changed from 40.7 ± 9.0% at baseline to 45.7 ± 12.6% (P = 0.078) at 6 months and 45.5 ± 11.2% (P = 0.013) at 12 months. Concomitant cataract surgery was a significant risk factor for CD loss. The probabilities of success or qualified success at 1 year were 66.1 and 83.6%, respectively. Most of the posterior segment complications, which were noted in 6 of 31 eyes (19%), were self-limiting, except for 2 eyes (6%) that developed retinal detachment as a consequence of kissing choroidal detachment.

Conclusions

Corneal endothelial damage was minimal, and the success probability was relatively high after ppAGV in refractive glaucoma cases.

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References

  1. Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DJ. TVT study group. Three-year follow up of the tube versus trabeculectomy study. Am J Ophthalmol. 2009;148:670–84.

    Article  PubMed  Google Scholar 

  2. Ramulu PY, Corcoran KJ, Corcoran SL, Robin AL. Utilization of various glaucoma surgeries in Medicare beneficiaries from 1995 to 2004. Ophthalmology. 2007;114:2265–70.

    Article  PubMed  Google Scholar 

  3. Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC. TVT study group. 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. Minckler DS, Francis BA, Hodapp EA, Jampel HD, Lin SC, Samples JR, et al. Aqueous shunts in glaucoma. A report of the American Academy of Ophthalmology. Ophthalmology. 2008;115:1089–98.

    Article  PubMed  Google Scholar 

  5. Chihara E, Kubota H, Takanashi T, Nao-I N. Outcome of white pump shunt surgery for neovascular glaucoma in Asians. Ophthalmic Surg. 1992;23:666–71.

    PubMed  CAS  Google Scholar 

  6. Lee E-K, Yun Y-J, Lee J-E, Yim J-H, Kim C-S. Changes in corneal endothelial cells after Ahmed Glaucoma Valve implantation: 2-year follow-up. Am J Ophthalmol. 2009;148:361–7.

    Article  PubMed  Google Scholar 

  7. Luttrull JK, Avery RL. Pars plana implant and vitrectomy for treatment of neovascular glaucoma. Retina. 1995;15:379–87.

    Article  PubMed  CAS  Google Scholar 

  8. Chihara E. Chap. 3. Glaucoma, seton surgery. In: Kitazawa K, editor. Ganka Shuzyutu-syo. Tokyo: Kanehara; 1995. p. 96–106.

  9. Arroyave CP, Scott IU, Fantes FE, Feuer WJ, Murray TG. Corneal graft survival and intraocular pressure control after penetrating keratoplasty and glaucoma drainage device implantation. Ophthalmology. 2001;108:1978–85.

    Article  PubMed  CAS  Google Scholar 

  10. Ritterband DC, Shapiro D, Trubnik V, Marmor M, Meskins S, Seedor J, et al. Cornea Glaucoma Implant Study Group (COGIS). Penetrating keratoplasty with pars plana glaucoma drainage devices. Cornea. 2007;26:1060–6.

    Google Scholar 

  11. Witmer MT, Tiedeman JS, Olsakovsky LA, Conaway MR, Prum BE. Long-term intraocular pressure control and corneal graft survival in eyes with pars plana Baerveldt implant and corneal transplant. J Glaucoma. 2010;19:124–31.

    PubMed  Google Scholar 

  12. Sidoti PA, Mosny AY, Ritterband DC, Seeder JA. Pars plana tube insertion of glaucoma drainage implant and penetrating keratoplasty in patients with co-existing glaucoma and corneal disease. Ophthalmology. 2001;108:1050–8.

    Article  PubMed  CAS  Google Scholar 

  13. Bourne WM, Nelson LR, Hodge DO. Central corneal endothelial cell changes over a ten year period. Invest Ophthalmol Vis Sci. 1997;38:779–82.

    PubMed  CAS  Google Scholar 

  14. Law SK, Coleman AL, Caplioli J. Dynamic tube movement of Ahmed Glaucoma valve. J Glaucoma. 2009;18:628–31.

    Article  PubMed  Google Scholar 

  15. Miyata K, Maruoka S, Nakahara M, Otani S, Nejime R, Samejima T, et al. Corneal endothelial cell protection during phacoemulsification: low- versus high-molecular-weight sodium hyaluronate. J Cataract Refract Surg. 2002;28:1557–60.

    Article  PubMed  Google Scholar 

  16. Hau S, Barton K. Corneal complications of glaucoma surgery. Curr Opin Ophthalmol. 2009;20:131–6.

    Article  PubMed  Google Scholar 

  17. Ogura Y, Takanashi T, Ishigooka H, Ogino N. Quantitative analysis of lens changes after vitrectomy by fluorophotometry. Am J Ophthalmol. 1991;111:179–83.

    PubMed  CAS  Google Scholar 

  18. Tsai JC, Johnson CC, Kammer JA, Dietrich MS. The Ahmed shunt versus the Baerveldt shunt for refractory glaucoma II. Longer-term outcomes from a single surgeon. Ophthalmology. 2006;113:913–7.

    Article  PubMed  Google Scholar 

  19. Smith M, Geffen N, Alashali T, Buys YM, Trope GE. Digital ocular massage for hypertensive phase after Ahmed Valve surgery. J Glaucoma. 2010;19:11–4.

    Article  PubMed  Google Scholar 

  20. Lee JJ, Park KH, Kim DM, Kim TW. Clinical outcome of Ahmed Glaucoma Valve implantation using tube ligation and removable external stents. Korean J Ophthalmol. 2009;23:86–92.

    Article  PubMed  CAS  Google Scholar 

  21. Wang JC, See JL, Chew PT. Experience with the use of Baerveldt and Ahmed Glaucoma drainage implants in an Asian Population. Ophthalmology. 2004;111:1383–8.

    Article  PubMed  Google Scholar 

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Acknowledgments

Editorial support was provided by NAI Co. Japan.

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Authors and Affiliations

  1. Sensho-kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto, 611-0043, Japan

    Etsuo Chihara & Mitsuyoshi Umemoto

  2. Department of Ophthalmology, Shimane University, Faculty of Medicine, 89-1 Enya, Izumo, 693-8501, Japan

    Masaki Tanito

Authors
  1. Etsuo Chihara
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  2. Mitsuyoshi Umemoto
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  3. Masaki Tanito
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Corresponding author

Correspondence to Etsuo Chihara.

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Chihara, E., Umemoto, M. & Tanito, M. Preservation of corneal endothelium after pars plana tube insertion of the Ahmed glaucoma valve. Jpn J Ophthalmol 56, 119–127 (2012). https://doi.org/10.1007/s10384-011-0108-1

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  • DOI: https://doi.org/10.1007/s10384-011-0108-1

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