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Jason Horowitz, Nariman Nassiri, Chaesik Kim, Justin Tannir, Anju Goyal, Shukairy Aman, Mark S Juzych, Bret A Hughes; Long-Term Outcome of Combined Implantation of Ahmed Valve Shunt and Intravitreal Flucinolone Acetonide in Uveitic Glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4968.
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© ARVO (1962-2015); The Authors (2016-present)
Combined Ahmed valve placement and intravitreal flucinolone acetonide (Retisert) implantation has been shown to reduce the number of glaucoma medications required to maintain healthy intraocular pressure (IOP) in patients with chronic uveitis at 12 and 24-month follow-ups. In this retrospective study, we aimed to investigate the long-term outcomes of combined Ahmed valve placement and Retisert implantation in patients with uveitic glaucoma at longer follow-up durations of up to 60 months.
We included patients who underwent combined Ahmed valve placement and Retisert implantation at the Kresge Eye Institute between October 2008 and March 2011. Demographic and clinical data were collected (Table 1). Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and number of IOP-lowering medications at each follow-up visit were compared with those at baseline (Table 2). Two-tailed Student’s t-test was used for statistical analysis. P value < 0.05 was considered as statistically significant.
A total number of 12 eyes of 9 patients with the mean ± SD age of 51.3 ± 9.1 were included in the study. Table 1 shows patients’ demographic and baseline clinical data. Compared to baseline, mean IOP was lower with a statistically significant reduction in IOP-lowering medications at all follow-up intervals, beginning 1 month postop (Table 2). At 60 months follow-up, mean IOP decreased from 19.3 ± 9.2 mm Hg at baseline to 13.8 ± 7.1 mm Hg (p=0.12), and the number of IOP-lowering medications reduced from 2.50 ± 1.24 at baseline to 0.75 ± 1.22 (p=0.005) (Table 2). In addition, statistically significant improvement in BCVA occurred from 3 months postop until 48 months postop (Table 2). At 48 months follow-up, BCVA (LogMAR) improved from 1.09 ± 0.83 (20/200 Snellen) at baseline to 0.22 ± 0.23 (20/40 Snellen) (p=0.004) (Table 2).
Combined Ahmed valve placement and Retisert implantation significantly reduced the number of IOP-lowering medications required to maintain healthy IOP in the management of uveitic glaucoma for up to 60 months after treatment.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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