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Abstract #9971 Published in IGR 5-3
Evaluation of the hypertensive phase after insertion of the Ahmed glaucoma valve
Nouri-Mahdavi K; Caprioli JAmerican Journal of Ophthalmology 2003; 136: 1001-1008
PURPOSE: To investigate the postoperative hypertensive phase (HP) in patients undergoing glaucoma drainage implant surgery. DESIGN: Interventional case series. METHODS: A retrospective chart review of 156 consecutive eyes (139 patients) who underwent placement of an Ahmed glaucoma valve (AGV) with a follow-up of ≥3 months was performed. Main outcome measures were occurrence and resolution of the HP and intraocular pressure (IOP) control. The HP was defined as IOP > 21 mmHg during the first three months after surgery. Resolution of the HP was defined as an IOP < 22 mmHg and an IOP reduction of 3 mmHg with the same or fewer number of glaucoma medications. RESULTS: An HP was observed in 88 eyes (56%). It occurred after a mean of 5.0 weeks (median, 4 weeks; range, 1-13 weeks) with an average (± standard deviation) peak IOP of 30.1 (± 7.5) mmHg. Resolution of the HP occurred in 19 of 68 eyes (28%) with available data. Eyes with an HP had a higher mean IOP and needed more medications six to 12 months after surgery than eyes without an HP (17.2 ± 5.6 versus 14.3 ± 5.8 mmHg; p = 0.012 and 1.7 ± 1.2 versus 0.3 ± 0.6 medications; p < 0.001, respectively). CONCLUSIONS: An HP occurs frequently after implantation of an AGV. However, it resolves in only a minority of eyes. The majority of eyes with an HP have no significant improvement of IOP control and continue to require the same number of glaucoma medications as they did during the HP.
Dr. K. Nouri-Mahdavi, Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, CA 90095, USA
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)