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AIM: To evaluate the efficacy and safety of endoscopic cyclophotocoagulation (ECP) and the Ahmed drainage implant in the treatment of refractory glaucoma after corneal transplantation. METHODS: Forty-six eyes of 46 patients with refractory glaucoma after corneal transplantation were assigned to either ECP or Ahmed tube shunt implantation. The operative energy of laser, changes of intraocular pressure (IOP), visual acuity and complications were observed. RESULTS: The mean postoperative IOP, at 6 months follow-up, 18.2 (plus or minus) 7.6mmHg (Ahmed) and 14.1 (plus or minus) 8.4mmHg (ECP) (P = 0. 04), were significantly different from baseline in both groups (P < 0.01). The mean number of glaucoma medications of ECP used was reduced from 2.3 preoperatively to 0.8 postoperatively, and Ahmed used was reduced from 2.4 preoperatively to 0.7 postoperatively. The difference was not statistically significant. Complications were choroidal detachment (Ahmed 6 eyes, ECP 2 eyes), shallow anterior chamber (Ahmed 5 eyes, ECP 0 eye), fibrous exudates (Ahmed 4 eyes, ECP 2 eyes), and hyphema (Ahmed 3 eyes, ECP 5 eyes). CONCLUSION: There are reliable curative effects of Ahmed Glaucoma Valve and ECP for the treatment of secondary glaucoma after corneal transplantation. Contrast with Ahmed Glaucoma Valve, ECP seems to be better in decreasing IOP in the long-time effect. The eyes that underwent Ahmed tube shunt implantation have more complications than those treated with ECP. LA: Chinese
G. Wei. Department of Ophthalmology, First Hospital of Xi'an, Institute of Ophthalmology, Xi'an 710002, Shaanxi Province, China. gaoweiz@163.com
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
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)