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Initial clinical experience with Ahmed glaucoma valve implants with scleral flap method in a rural population of Central India

Poster Details

First Author: C.Kalamkar INDIA

Co Author(s):    N. Radke   G. Behera   A. mukherjee   s. radke     

Abstract Details

Purpose:

To report initial experience from patients of a marginalized and economically backward community in rural and tribal Central India who presented to us with refractory glaucoma. Primary purpose was to elucidate the indications and outcomes of Ahmed Glaucoma Valve (AGV Model FP-7, New World Medical Inc., Rancho Cucamonga, CA) in this population.

Setting:

A tertiary eye care centre in rural central India. All patients were screened and treated at our referral tertiary eye care hospital- Shri Ganesh Vinayak Eye Hospital (SGVEH)

Methods:

Retrospective,consecutive non randomized hospital based case series of 23 consecutive adult eyes with refractory glaucoma undergoing AGV from October 2012 onwards. All patients underwent complete ophthalmic evaluation with documentation of anterior and posterior segment. Pre-operative and post-operative BCVA, intra-ocular pressure (IOP), use of additional medical therapy and surgical complications was done. Minimum follow-up of 6 months was considered. Failure was considered if IOP was found to be ≤ 5 mm of Hg or ≥ 21 mm of Hg. Partial thickness scleral flap method was used in all the cases.

Results:

AGV implantation with scleral flap method was done for all patients (Neovascular glaucoma-11, uveitic glaucoma-3, failed trabeculectomy primary angle closure glaucoma-5, advanced primary angle closure glaucoma-3, post-traumatic glaucoma-1). average pre-treatment IOP reduced from 49.48 ±4.75 mm to 16.78 ±2.04 mm post-operatively at last follow-up (p<0.01). IOP was controlled in 19 patients (82.61%) without any additional medications and in 4 cases(17.4%) IOP was controlled with additional anti-glaucoma topical medications . Immediate complications encountered were Hyphema-2 patients (8.69%), Tube endothelial touch-1 patient (4.35%) and Tube opening plugged by iris-1 patient (4.35%). All 4 patients subsequently recovered.

Conclusions:

AGV implantation is a very good and reliable method in managing our sub-group of adult refractory glaucoma. Our results were comparable with previously published reports with low complication and failure rates. Popularity of glaucoma drainage devices is still low in our region, which is preferable in this sub-group of refractory glaucoma patients,where conventional glaucoma surgery is likely to fail. Randomized clinical studies with long term follow up and larger sample size would be beneficial for us to confirm these initial outcomes. FINANCIAL DISCLOUSRE: NONE

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