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First Author: R.Massa PORTUGAL
Co Author(s): J. Queirós B. Pessoa I. Sampaio C. Aguiar M. Menéres
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To present a case report of different medical and surgical management of encapsulated cyst following Ahmed glaucoma valve implant insertion.
Ophthalmology Department of Centro Hospitalar do Porto Hospital de Santo António in Oporto, Portugal.
Patients data including clinical ophthalmologic evaluations complemented with medical and surgical procedures documented with photographies.
A 38-year-old man ,healthy, was admitted to the Emergency Department with a left ocular perforation. The ophthalmologic evaluation revealed the best corrected vision of hand movements in this eye. Biomicroscopy revealed a corneal laceration with iris herniation and traumatic cataract. An emergency surgery was performed. Four days later, a pars plana vitrectomy left the patient aphaquic and tamponade with silicone oil. Silicone oil was removed and a scleral fixation intraocular lens with an artificial iris implant was implanted. Raised intraocular pressure (IOP) was noticed some weeks later and wasnt controlled by medical therapy. The patient underwent an Ahmed glaucoma valve implant insertion and IOP was controlled without medication. One month later an encapsulated cyst around Ahmed valve was surgically excised. Two weeks later, a bigger encapsulated cyst was observed and a conservative therapy with timolol 0.5% was initiated with a reduction of the cyst. Two aspirations with a 25 gauge needle were performed. After these procedures, the cyst was removed and biologic glue OcuSeal® was used between cysts fibrous capsule and conjunctiva. Since then IOP is controlled without medication and there is no evidence of new cysts.
Encapsulated cysts after Ahmed glaucoma valve implant insertion constitute a cause of pain and elevated intraocular pressure (not verified in this case). This case illustrates the evolution of different approaches to encapsulated cysts around Ahmed valves, focusing the results achieved with the use of biologic glue.