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A. Aue, C. Hirn, C. Vass; Long–Term Follow–Up of Chronic Glaucoma Patients After Ahmed–Valve Implantation and Comparison of Its Function Depending on the Location of the Implant . Invest. Ophthalmol. Vis. Sci. 2006;47(13):37.
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© ARVO (1962-2015); The Authors (2016-present)
The comparison of long–term follow–up results of patients with chronic glaucoma after Ahmed valve implantation in relation to the location of the implant.
A retrospective evaluation of 58 eyes of 56 patients with chronic glaucoma who received an Ahmed valve implantation because of uncontrollable chronic glaucoma progression. We analyzed visual acuity (VA), changes in visual field (VF) using a Humphrey 30–2, the intraocular pressure (IOP) and the medication needed for lowering the IOP pre and post operatively. VA was obtained before operation and at the end of follow–up. VF was obtained before operation, as well as 3, 6 and 12 month after operation, then annually. IOP was averaged before operation, after operation at day 1, 2, week 1, 2, month 1, 3, 6 and 12, then annually. After implantation IOP lowering medication was added when necessary.
We evaluated 58 eyes of 56 patients with chonic glaucoma. 34 eyes of 32 patients received the Ahmed–valve implant on the temporal superior side (TS), 13 eyes at the nasal superior side (NS), 5 eyes at the temporal inferior side (TI) and 6 eyes on the nasal inferior side (NI), respectively. The location was dependent on the possible approach to the implantation side due to scarring of previous operations. All eyes had an average of 2.4 (0 to 7) previous operations. The most were in the NI group with 4, the lowest in the TS group with 2.3. The mean follow–up period for all patients was 33 months ranging from 0 to 72. The mean VA before operation was 0.8 logmar and 1.3 logmar at the end of follow–up. The VF remained stable over the follow–up period with an averaged MD of –15.4 before implantation and –12.6 at the last follow–up. The average IOP was 30 mmHg before operation with an averaged therapy of 3.2 IOP lowering substances. The highest IOP pre operatively was 35.5 mmHg in the NI group, the lowest 20.8 mmHg in the TI group. The medication before operation ranged from 2.6 substances for the TS group, to 3.5 substances for the TI group. At the 60 month follow–up the average IOP was 14.9 mmHg with an average of 1.3 substances. The highest IOP of 16.5 mmHg was in the TS group, the lowest of 11.5 mmHg in the NS group.
Ahmed valve is an effective method for lowering IOP in patients with chronic glaucoma when conventional therapy or first line operating procedures fail to prevent progression of optic nerve damage. There was no difference in the function of the Ahmed–valve in the different locations.
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