Purchase this article with an account.
A. Lakshmanan, M. Mathew, N. Mathew, H. El-Defrawy, A. W. King, H. S. Dua; Ahmed Valve Implantation in Eyes Undergoing Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4692.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of Ahmed valve (AV) implantation in patients undergoing penetrating keratoplasty (PKP)
In total, 16 patients (17 eyes) undergoing PKP who also underwent AV implantation were retrospectively reviewed. Visual acuity, intraocular pressure (IOP), and glaucoma medications at the most recent examination prior to surgery, were compared with those of last postoperative examination. The surgical success was defined as IOP less than 21 mmHg and greater than 4 mmHg without loss of light perception and visually devastating complications at the last postoperative examination. Decrease in the number of glaucoma medications was also a criterion for surgical success.
The mean follow-up period was 32 months +/- 19.8 months. The mean preoperative and postoperative IOPs were 36.7+/-15.6 (range, 20-89) mmHg and 14.0+/-2.5 (range, 10-18) mmHg respectively (P<0.0001). The mean number of glaucoma medications was 3.0+/-1.0 (range, 2-5) preoperatively and 1.49+/-1.27 (range, 0-4) postoperatively (P<0.0001). The most common intra-operative complication was conjunctival buttonholing. Post-operatively valve occlusion (five eyes, 29.4%) was the most commonly observed complication. Surgical success was achieved in 12 eyes (70.5%). In three eyes AV was replaced, one required AV revision and one became phthisical. These were considered as failures.
Implantation of AV is an effective surgical procedure in the management of refractory glaucoma in eyes prior to corneal graft surgery or glaucoma after penetrating keratoplasty. Post-operative inflammation might contribute to the occurrence of valve occlusion, which is the most common complication. Prevention of this complication is an essential factor for improving the surgical outcome.
This PDF is available to Subscribers Only