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Abstract #92455 Published in IGR 22-1
Anterior Chamber Versus Ciliary Sulcus Ahmed Glaucoma Valve Tube Placement: Longitudinal Evaluation of Corneal Endothelial Cell Profiles
Godinho G; Barbosa-Breda J; Oliveira-Ferreira C; Madeira C; Melo A; Falcão-Reis F; Estrela-Silva SJournal of Glaucoma 2021; 30: 170-174
PRCIS: An Ahmed glaucoma valve (AGV) tube in the ciliary sulcus (CS) is safer for the endothelium. At 4 years of follow-up, there was a significant decrease in endothelial cell count only with anterior chamber (AC) placement. PURPOSE: Corneal endothelium (CE) damage is one of the most feared long-term complications that can result from glaucoma drainage devices. Nonetheless, there is a lack of studies evaluating longitudinal changes in CE cells. This study aims to compare CE changes after AGV implantation in eyes with AC or CS tube placement. MATERIALS AND METHODS: This was a retrospective, nonrandomized, longitudinal study of pseudophakic eyes with open-angle glaucoma and medically uncontrolled intraocular pressure that received an AGV. Eyes with additional glaucoma surgeries performed during follow-up were excluded. The main outcome measure was endothelial cell density (ECD), which was evaluated 1 year±2 months and 4 years±2 months postoperatively. The average endothelial cell size (AS) and the distance from the tube tip to the cornea were also evaluated. RESULTS: Twenty-six eyes from 26 patients, with a mean age of 73±10 years, were included. The tube was placed in the AC in 15 eyes and in the CS in 11 eyes. The eyes with tube placement in the AC showed a significant AS increase (P=0.007) and ECD decrease (P=0.034), whereas eyes with tube placement in the CS had no significant AS (P=0.575) or ECD (P=0.445) change. In the eyes with tube placement in the AC, there was no correlation between DTC and ECD (P=0.260) or AS (P=0.428) changes. CONCLUSIONS: Tube placement in the AC seems to lead to significant CE cell loss over time, compared with tube placement in the CS.
Department of Ophthalmology, Centro Hospitalar e Universitário São João.
Full articleClassification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)