Dataset Information

Intraluminal stenting versus external ligation of Ahmed glaucoma valve in prevention of postoperative hypotony.

ABSTRACT:

Aim

To compare intraluminal stenting and external ligation of Ahmed glaucoma valves (AGV) for refractory glaucoma management and postoperative hypotony prevention.

Methods

This randomized prospective blind study included 30 eyes of 25 patients (age range: 44-56y) with refractory glaucoma. This study was conducted from September 2018 to January 2020. The study included two groups, AGV with intraluminal stenting group (n=15 eyes) and AGV with external ligation group (n=15 eyes). Follow-up period was one year postoperatively. The primary outcome was intraocular pressure (IOP) and its association with the number of postoperative glaucoma medications. IOP≤21 mm Hg without medications indicated complete success while IOP≤21 mm Hg with medications indicated qualified success; and IOP<6 mm Hg was defined as hypotony.

Results

After a year of follow-up, IOP was significantly reduced in the intraluminal stenting group than in the external ligation group (11.67±0.89 vs 14.2±4.0 mm Hg, respectively, P=0.024). Postoperative hypotony was more common in the external ligation group (2 cases, 13.33%) than in the intraluminal stenting group (1 case, 6.67%).

Conclusion

Application of intraluminal stenting or external ligation during AGV surgery usually prevents postoperative hypotony (transient and persistent) that occurs in conventional AGV surgery.

SUBMITTER: Abd Elfattah D

PROVIDER: S-EPMC8481999 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Intraluminal stenting versus external ligation of Ahmed glaucoma valve in prevention of postoperative hypotony.

Abd Elfattah Dina D Wagdy Faried F Mokbel Tharwat T Elsorogy Hisham H Elhesy Abd-Elmonem A AA

International journal of ophthalmology 20211018 10

<h4>Aim</h4>To compare intraluminal stenting and external ligation of Ahmed glaucoma valves (AGV) for refractory glaucoma management and postoperative hypotony prevention.<h4>Methods</h4>This randomized prospective blind study included 30 eyes of 25 patients (age range: 44-56y) with refractory glaucoma. This study was conducted from September 2018 to January 2020. The study included two groups, AGV with intraluminal stenting group (<i>n</i>=15 eyes) and AGV with external ligation group (<i>n</i> ...[more]

PMID: 34667733

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Project description:IntroductionThis study compared the safety and efficacy of sutureless Ahmed glaucoma valve surgery (AGV standalone) to sutureless AGV plus cataract surgery (AGV-CEIOL) in Black or Hispanic patients.MethodsRecords from Black or non-white Hispanic patients who received either AGV standalone or AGV-CEIOL from 2014 to 2019 at a Bronx, New York practice were reviewed. All surgeries were performed using a sutureless technique with Tisseel fibrin glue. Primary outcomes included failure (defined as intraocular pressure (IOP) > 21 mmHg, ≤ 5 mmHg, or reduced by < 20% after the first 3 months; loss of light perception; or reoperation for glaucoma), hypertensive phase, IOP changes, and medication changes. Secondary outcomes included postoperative complications and interventions.ResultsA total of 203 eyes that received AGV standalone (n = 78) or AGV-CEIOL (n = 125) were analyzed. Mean follow-up duration was 42.2 ± 17.5 months, with similar cohort-specific intervals (P = 0.68). Failure among AGV-CEIOLs (44.8%, n = 56) and AGV standalones (47.4%, n = 37) occurred at similar frequencies; log-rank testing indicated comparable 5-year survival (P = 0.56). Mean IOP among AGV-CEIOLs (15.8 ± 12.1 mmHg) was greater than standalones (8.6 ± 5.1 mmHg) at post-op day 1 (P < 0.001). The AGV-CEIOL group had a 60% lower odds of experiencing a hypertensive phase after adjustment for baseline group differences (P = 0.01). Five-year IOP reduction was similar between groups in the multivariable model (P = 0.45). There were no significant differences in medications (P > 0.05 at all time points) or in total complications (P = 0.28). More standalones required reoperation (39.7%, n = 31) compared to AGV-CEIOLs (21.6%, n = 24; P = 0.007).ConclusionsSutureless AGV-CEIOL was noninferior to sutureless AGV standalone when performed in Black or non-white Hispanic patients. The combined group experienced the hypertensive phase less frequently despite higher day 1 IOP.

Project description:PurposeThe aim of this study was to evaluate the efficacy and safety of the Ahmed glaucoma valve in pediatric patients with refractory glaucoma.MethodsA comprehensive literature search was conducted across multiple major databases, including PubMed, Embase, the Cochrane Library of Systematic Reviews, Science Direct, China's National Knowledge Infrastructure, and the Wanfang database. We retrieved studies published before December 2022 that met the inclusion criteria, including clinical controlled trials (randomized controlled trials) and clinical noncontrolled trials (non-randomized controlled trials) on the use of Ahmed glaucoma valve in pediatric patients with refractory glaucoma. We performed a meta-analysis and systematic review. The efficacy measures included intraocular pressure, number of anti-glaucoma medications, visual acuity, and success rate. The safety measures were complications. Statistical analysis was performed using RevMan 5.0 software.ResultsWe identified 46 eligible studies: Compared with geographic location and study type, the Ahmed glaucoma valve showed a decrease in postoperative intraocular pressure and number of anti-glaucoma medications compared to preoperative levels in children with refractory glaucoma (P < 0.001). Compared with etiological, the Ahmed glaucoma valve showed a decrease in intraocular pressure after surgery compared to preoperative levels in children with refractory glaucoma (SMD: 14.57, 95% CI: 14.05-15.08, P < 0.00 1), and a decrease in postoperative number of anti-glaucoma medications compared to preoperative number of anti-glaucoma medications (SMD: 1.45, 95% CI: 1.37-1.54, P < 0.001). Compared with trabeculectomy revision surgery, there was no significant difference in the complete success rate between the two groups (SMD: 0.86, 95% CI: 0.52-1.39; P = 0.37).Overall, the postoperative intraocular pressure at the time of Ahmed glaucoma valve implantation was lower than that at the time of trabeculectomy revision surgery (SMD: 1.01, 95% CI: 0.71-1.31, I2 = 99%, P < 0.001). Subgroup analyses based on whether mitomycin C was use d or not. There was a statistically significant difference in intraocular pressure between Ahmed's glaucoma valve surgery and preoperative (SMD: 14.13, 95% CI: 13.47-14.80, P = 0.007). Comparison of cumulative complete success rates of Ahmed S2, S3, and Ahmed FP7, FP8 in Ahmed glaucoma valve surgery (SMD: 0.74, 95% CI: 0.38-1.45, I2 = 85%, P = 0.38). There is no statistical difference between the two groups. Choroidal effusion and anterior chamber hemorrhage are the two most common adverse events after Ahmed's glaucoma valve surgery.ConclusionsThe Ahmed glaucoma valve implantation has some effectiveness in reducing intraocular pressure in children with refractory glaucoma, but there are still many complications. Valve model may not be the key factor affecting the postoperative effectiveness and adverse reactions of refractory glaucoma in children.

Dataset Information

Intraluminal stenting versus external ligation of Ahmed glaucoma valve in prevention of postoperative hypotony.

Aim

Methods

Results

Conclusion

Publications

Intraluminal stenting versus external ligation of Ahmed glaucoma valve in prevention of postoperative hypotony.

Similar Datasets

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