September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Endothelial Cell Loss and Surgical Outcomes after Ahmed Glaucoma Valve Implantation through Ciliary Sulcus Versus Anterior Chamber
Author Affiliations & Notes
  • Eun Min Kang
    Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul , Korea (the Republic of)
  • Si Hyung Lee
    Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul , Korea (the Republic of)
  • Hyoung Won Bae
    Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul , Korea (the Republic of)
  • Chan Yun Kim
    Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul , Korea (the Republic of)
  • Footnotes
    Commercial Relationships   Eun Min Kang, None; Si Hyung Lee, None; Hyoung Won Bae, None; Chan Yun Kim, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6502. doi:
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      Eun Min Kang, Si Hyung Lee, Hyoung Won Bae, Chan Yun Kim; Endothelial Cell Loss and Surgical Outcomes after Ahmed Glaucoma Valve Implantation through Ciliary Sulcus Versus Anterior Chamber. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6502.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To reduce the risk of corneal endothelial cell loss, tube insertion through ciliary sulcus has been considered as alternatives to anterior chamber insertion of the tube in pseudophakic/aphakic patients. However, there are no reports comparing the endothelial cell loss of ciliary sulcus and anterior chamber insertion of the Ahmed glaucoma valve (AGV). This study tested the hypothesis that endothelial cell loss in the ciliary sulcus insertion of AGV is less than that in the anterior chamber insertion of AGV.

Methods : This was a single-center, retrospective comparative study. The medical records of 20 eyes with ciliary sulcus implantation of AGV were reviewed and were compared with 20 eyes with the anterior chamber AGV implantation. Both the case and control groups were matched for glaucoma type, age, sex, underlying disease, and preoperative intraocular pressure (IOP). The postoperative endothelial cell counts, glaucoma medications, complications, success rate and IOP in the 2 groups were compared. All surgeries were performed by 1 surgeon. The data was analyzed using a Mann-Whitney U test, Fisher’s exact test, Kaplan-Meier survival curve and a Wilcoxon signed rank test.

Results : The average follow-up period was 17.29 ± 14.70 months for the ciliary sulcus implantation group and 22.00 ± 14.77 months for the anterior chamber implantation group. The average loss of endothelial cells in percentages for the ciliary sulcus implantation and anterior chamber implantation groups were 6.93 ± 7.06 % and 14.03 ± 7.75 %, respectively, with significant difference between the 2 groups (p = 0.02). Success rates at final follow-up were similar, 73.7% for the ciliary sulcus implantation group and 84.4% for anterior chamber implantation group. Kaplan-Meier survival curve analysis showed no significant difference between the 2 groups (P=0.495). No difference in IOP control, the number of postoperative glaucoma medications and postoperative complications were observed between the 2 groups.

Conclusions : Endothelial cell loss in the ciliary sulcus implantation group appeared to be less than that in the anterior chamber implantation group while maintaining similar level of postoperative IOP control in pseudophakic/aphakic eyes without vitrectomy. Therefore, ciliary sulcus implantation of AGV may be preferred for glaucoma patients with decreased endothelial cell count.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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