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S. H. Teixeira, L. M. Doi, A. L. F. Silva, K. Duarte, F. S. Higa, M. Mendonca, J. A. Prata, Jr., A. Paranhos, Jr.; Comparison of Efficacy Between Silicone Ahmed Glaucoma Valves With and Without Intravitreal Triamcinolone Injection. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3961.
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To evaluate the efficacy between silicone Ahmed valves with and without intravitreal triamcinolone injection in patients with neovascular glaucoma.
Forty nine patients with uncontrolled neovascular glaucoma were selected and randomized into two groups. Patients from group 1 had glaucoma surgery using Ahmed silicone glaucoma valve and patients from group 2 had glaucoma surgery using Ahmed silicone glaucoma valve plus intravitreal injection of triamcinolone acetate, 0.1 mL at the same time. All patients had high, clinically uncontrolled intra ocular pressure (IOP) secondary to anterior segment neovascularization caused by diabetic retinopathy or retinal vein occlusion. Success was defined as IOP lower then 21 with no more than two antiglaucoma drugs. Statistical analysis was performed with Kaplan Meier survival analysis and Log rank for the difference between the groups.
Group 1 had 28 eyes (12 female) and group 2 had 21 (4 female). Race distribution was 41.7% blacks and 58.3% white in group 1 and 47.8% blacks, 47.8% white and 4.3% yellow in group 2. The initial mean IOP was 47.7mmHg (SD 13.1) in group 1 and 42.1mmHg (SD 9.8) in group 2 with similar mean number of glaucoma medications (2.3 in group 1 and 2.7 in group 2). Survival analysis showed higher success rate in group two (with triamcinolone) compared to group one (Log rank: p<0,033).
Our data suggest that silicone Ahmed Glaucoma Valve combined with the use of intravitreal triamcinolone injection might promote a better IOP control in neovascular glaucoma.
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