Authors
Starostina A.V., Alferova E.A., Adzhieva A.A., Sidorova A.V.
S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow
Abstract
The choice of surgical treatment method for patients with refractory glaucoma of various etiologies is quite complicated. The most commonly performed surgeries are implantation of drainage devices or laser treatment methods. This article presents the results of repeated drainage surgery with Ahmed valve implantation in patients with previously implanted Ex-press shunt in patients with different types of refractory glaucoma.
Objective. To present the results of surgical treatment of patients with advanced refractory glaucoma with implantation of Ahmed valve drainage after previous implantation of Ex-Press shunt.
Methods. The study included 10 patients (10 eyes) with refractory glaucoma of various etiologies who had previously undergone Ex-Press implantation and subsequently received surgery with Ahmed valve implantation.
Results. After surgical treatment, a statistically significant decrease in the level of intraocular pressure was detected in all cases. In the early postoperative period, in one case a choroidal detachment was detected. In the early postoperative period and also during the whole period of follow-up the drainage tube was in the correct position in anterior chamber. By the 6th month of follow-up hypotensive drops were required in 5 patients.
Conclusion. At decompensation of intraocular pressure after antiglaucoma surgery with Ex-Press microshunt in patients with refractory glaucoma implantation of Ahmed valve drainage showed efficacy up to 3 years.
Keywords: Ahmed valve, refractory glaucoma, Ex-Press implant.
References
1. Bo W, Dai D, Sun F. Observation of curative effects of Ex-PRESS and AGV implantation in the treatment of refractory glaucoma. Exp Ther Med. 2018 May;15(5):4419-4425. doi: 10.3892/etm.2018.5977.
2. Zhang M, Li B, Sun Y. EX-PRESS and ahmed glaucoma valve in treatment of refractory glaucoma. Acta Ophthalmol. 2016 Aug;94(5):e382-3. doi: 10.1111/aos.12898.
3. Bikbov MM, Khusnitdinov II. Analysis of the hypotensive effect of Ahmed valve implantation in refractory glaucoma National Journal glaucoma. 2016;15 (3):23-33. (In Russ).
4. Sidorova A.V., Khodjaev N.S., Starostina A.V. The potential of ExPRESS Mini Glaucoma Shunt implantation in the treatment of secondary glaucoma induced by silicone oil emulsification in patients after vitrectomy. National Journal glaucoma. 2017;16(2):57-62. (In Russ.)
5. Sidorova AV, Starostina AV, Pecherskaia MA, Khabazova MR, Arisov AA. The Study of the Efficiency of Micropulse Transscleral Cyclophotocoagulation in the Combined Treatment of Patients with Secondary Neovascular Glaucoma. Journal of Clinical Practice. 2021;12(4):44–50. (In Russ.) doi: https://doi.org/10.17816/clinpract89576.
6. Sidorova AV, Khodzhaev NS, Eliseeva MA, Starostina AV. Drainage surgery for refractory glaucoma combined with micropulse cyclophotocoagulation. Saratov Journal of Medical Scientific Research 2020; 16 (1): 273–276.
7. Egorova EV., Sokolovskaya TV., Uzunyan DG., et al. Evaluation of the results of contact transcleral diode-laser cyclocoagulation taking into account changes in the ciliary body during the study by ultrasound biomicroscopy in patients with terminal glaucoma. Ophthalmosurgery. 2013;3:72-7. (In Russ).
