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Abstract #59631 Published in IGR 16-3

Glaucoma in Modified Osteo Odonto Keratoprosthesis Eyes: Role of Additional Stage 1A and Ahmed Glaucoma Drainage Device - Technique and Timing

Iyer G; Srinivasan B; Agarwal S; Shetty R; Krishnamoorthy S; Balekudaru S; Vijaya L
American Journal of Ophthalmology 2015; 159: 482-9.e2

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PURPOSE: To report the technique, timing and outcomes of the Ahmed glaucoma drainage device in eyes with the modified osteo odonto keratoprosthesis (MOOKP) and the role of an additional Stage 1 A to the Rome-Vienna protocol. DESIGN: Retrospective interventional case series PATIENTS & METHODS: Case records of 22 eyes of 20 patients with high intraocular pressure at various stages of the MOOKP procedure performed in 85 eyes of 82 patients were studied. Stage 1A which includes total iridodialysis, intracapsular cataract extraction and anterior vitrectomy was done in all eyes as the primary stage. RESULTS: 17 Ahmed glaucoma drainage devices were implanted in 15 eyes of 14 patients [chemical injury in 9 (10 eyes) and Stevens Johnson Syndrome in 5 patients]. It was performed during and after stage 1A in 2 and 7 eyes respectively, after Stage 1B+1C in 1 eye and after Stage 2 in 6 eyes. 11(73.3%) of 15 eyes remained stable with adequate control of intraocular pressure over a mean follow up period of 33.68 months (1-90 months). Complications related to the drainage device were hypotony in 1 eye and vitreous block of the tube in 1 eye. CONCLUSION: It is ideal to place the Ahmed glaucoma drainage device prior to the mucosal graft when the anatomy of the ocular surface is least altered with best outcomes. The technique of placement of the drainage device during the various stages of the MOOKP procedure has been described. The intraocular pressure stabilized in 3/4(th) of the eyes with pre-existing glaucoma.

Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai - 600006, Tamil Nadu, India. Electronic address: drgeethaiyer@gmail.com.

Full article

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Classification:

9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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