Efficacy And Safety Of Temporary In Situ Stenting Of Ahmed Glaucoma Valve In Eyes With High Risk Of Hypotony
Published 2023 - 41st Congress of the ESCRS
Reference: FP04.12 | Type: Free paper | DOI: 10.82333/1z41-fe58
Authors: Abdullah Omar Al Houssien* 1 , Adi Al Owaifeer 2 , Sameer Ahmad 3 , Ohood Owaidhah 4 , Rizwan Malik 5
1Fellowship and Residency Training Program,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, 2Research Department,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia;Department of Ophthalmology,King Faisal University,Al Hasa,Saudi Arabia, 3Department of Ophthalmology,Howard University Hospital,Washington,United States;Department of Ophthalmology and Visual Sciences,University of Maryland School of Medicine,Baltimore,United States;Glaucoma Consultants of Washington,Herndon,United States, 4Glaucoma Division,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, 5Department of Ophthalmology,Sheikh Khalifa Medical City,Abu Dhabi,United Arab Emirates
Purpose
To describe a novel technique for providing external ligation of the Ahmed glaucoma valve (AGV) to prevent hypotony in eyes at high risk with a 4/0 nylon stent suture and report outcomes compared to ligation with an absorbable vicryl suture and no ligation in terms of efficacy and safety.
Setting
A retrospective study that was conducted to review patients in the period between January 2017 and December 2020 at the Glaucoma Clinics of King Khaled Eye Specialist Hospital.
Methods
This was a retrospective cohort study investigating the efficacy and safety of in situ stenting compared to an absorbable ligature and the standard care, in high risk eyes, of hypotony. It included 116 patients; 34 in Group A (ligation + stent), 27 in Group B (ligation – stent), and 55 in Group C (no ligation).
Results
The mean age was 53.94±19.01 in Group A, 44.85±29.92 in Group B and 52.62±24.47 in Group C. The follow-up period was at least 6 months. The mean baseline Snellen VA (LogMAR) was 1.82±1.34, 1.30±0.98 and 1.34±1.07 and the mean baseline IOP was 32.50±9.48, 28.22±7.12 and 28.33±10.63 mmHg, in Groups A, B and C, respectively. The failure rates, by the Kaplan Meier Survival curve, were higher 27.3% in Group C (no ligation) compared to 20.6% in Group A (ligation + stent) and 18.5% in Group B (ligation – stent) yet not found to be statistically significant (p = 0.4; log rank test). There was lower hypotony 2.9% in Group A and lower complications 25.9% in Group B but no statistical significance was found amongst the groups.
Conclusions
In conclusion, temporary nylon in situ stenting of AGV had lower rates of hypotony. Furthermore, lower failure and complication rates were observed in vicryl only ligated AGV, then nylon in situ stented AGV and lastly in standard AGV controls.