May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
2nd Ahmed Valve Insertion in the Same-Eye
Author Affiliations & Notes
  • M. Smith
    Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada
  • Y. M. Buys
    Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada
  • G. E. Trope
    Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships  M. Smith, None; Y.M. Buys, None; G.E. Trope, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 1250. doi:https://doi.org/
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    • Get Citation

      M. Smith, Y. M. Buys, G. E. Trope; 2nd Ahmed Valve Insertion in the Same-Eye. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1250. doi: https://doi.org/.

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

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Abstract
 
Purpose:
 

To examine the results of same-eye second GDD insertion in eyes with refractory glaucoma despite previous Ahmed GDD insertion.

 
Methods:
 

Non comparative retrospective case series.

 
Results:
 

21 patients who underwent insertion of two glaucoma drainage devices into the same eye between January 1999 and November 2007 were identified. 19 patients had follow up of at least 1 year and were included in the analysis. All surgeries involved Ahmed GDDs and were performed by a single surgeon (GT). Mean age at time of surgery was 58 years (median 60, range 37-81). Mean number of previous trabeculectomies in the operated eyes was 1.74 (median 2, range 0 to 4). The mean interval between insertion of the first and second Ahmed valves was 24.2 months (median 17, range 4-67). Mean follow up interval was 38.8 months (median 35 months, range 12-80 months).The IOP, number of glaucoma medications and LogMAR visual acuity (VA) at 12 months and at final follow-up was examined, and the results are shown in the table. P values are based on comparison with preoperative values using a Wilcoxon test, with a value of ≤0.05 considered to be statistically significant. The mean drop in IOP at 12 months and at final follow up was 8mmHg (43%) and 9.9mmHg (42%) respectively. Although the mean VA was poorer post-operatively this did not reach levels of statistical significance.16 of the 19 patients (84.2%) achieved IOP of ≥5mmHg and ≤21 mm Hg and ≥20% decrease on IOP prior to second GDD insertion with or without glaucoma drops.One patient required anterior chamber reformation on the first post-operative day and another suffered corneal decompensation which resulted in a decrease in VA from 20/70 pre-operatively to counting fingers post-operatively.

 
Conclusions:
 

In eyes with refractory glaucoma where IOP remains uncontrolled despite an Ahmed GDD insertion of a second GDD is effective in improving IOP control.  

 
Keywords: intraocular pressure 
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