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Ahmed valve surgery in post penetrating keratoplasty glaucoma: retrospective study

Poster Details

First Author: M.Noronha PORTUGAL

Co Author(s):    R. Anjos   N. Silva   V. Lemos   N. Alves   T. Gomes   P. Candelaria     

Abstract Details

Purpose:

To study the results obtained in our center, Centro Hospitalar Lisboa Central, in the use of Ahmed valve (AV), in a sub-group of patients with post-penetrating keratoplasty (PK) glaucoma.

Setting:

Centro Hospitalar Lisboa Central Department of Ophthalmology.

Methods:

Of an initial group of 120 eyes, 10 eyes of 10 patients which had AV surgery after PK were chosen retrospectively. All 10 eyes were submitted to a full ophthalmological exam. Mean intraocular pressure (IOP), antiglaucoma medication and the existence of graft failure were quantified at pre-surgery and 1 day, 1 week, 1 month, 3 months, 6 months and 12 months after surgery. Absolute success was defined as IOP inferior to 21 mmHg without antiglaucoma medication and without graft failure. Relative success was defined as IOP inferior to 21 mmHg with or without antiglaucoma medication and without graft failure.

Results:

Mean age was 63,3+/-15,0 years. AV implant was done 7,7 +/-6,2 months after PK. Mean IOP and antiglaucoma medication (n) were significantly reduced (p value less than 0,05) from pre-surgery values of 32,4+/- 5,0 mmHg (n= 3,2+/-0,6) to post-surgery values of 13,6+/-3,4 (n= 0); 13,2+/-3,6 (n=0); 17,3+/-9,9 (n= 0,1+/-0,3); 16,8+/-3,3 (n= 1,0+/-1,4); 16,3+/-5,4 (n= 1,2+/-1,2); 14,5+/-3,0 (n=1,3+/-1,3), at 1 day, 1 week, 1 month, 3 months, 6 months and 12 months time. Graft failure occurred in 4 of 10 eyes (40%), with need of new PK, during the study time. At 12 months absolute success rate was 20% and relative success rate was 60%.

Conclusions:

Post-PK glaucoma is an ophthalmological challenge. It is essential to provide fast surgical and/or medical treatment. Our results, while obtained retrospectively and with small sample size, were favourable to the use of AV in decreasing IOP and antiglaucoma medication in post-PK glaucoma. Graft failure and its relation with AV will have to be further studied.

Financial Disclosure:

NONE

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