Abstract
Purpose :
To evaluate the outcomes in Ahmed valve implantation (AVI) alone and with antiangiogenic therapy between patients with neovascular glaucoma secondary to diabetic retinopathy (DR) and central vein occlusion (CVO)
Methods :
Descriptive, retrospective study. We included all the patients who attended our hospital from January 2007 to August 2018, whose diagnosis was Neovascular Glaucoma caused by diabetic retinopathy or central retinal vein occlusion, and were treated with Ahmed valve implantation alone or with antiangiogenic therapy. The exclusion criteria were patients with previous diagnosis of other types of glaucoma, patients who were not operated in our hospital and those who didn’t have at least 6 months of follow up
Results :
From January 2007 until January 2017 (final outcomes in January 2018), the hospital received 6027 patients with diagnosis of Neovascular Glaucoma. The total number of patients treated with Ahmed valve implantation (AVI) was 2058 individuals, 666 (32.36%) had neovascular glaucoma, we have excluded 89 cases whose surgery was performed in another hospital and 26 patients who didn’t have a 6 month follow up. So far, analysis is made of 551 patients (556 eyes), from which 313 (56.80%) are males and 238 (43.19%) were females. The age range is 29 to 81 years (mean 56.59 years). Sixty eight eyes have NVG secondary to CVO and 488 eyes, secondary to DR. We are comparing best corrected visual acuity, use of hypotensive drugs and cup-to-disc ratio before and after AVI until their last visit to our service. Previous, 24-hours later and last Intraocular pressure measures are also being compared; until now we have registered an average of previous IOP of 38.85mmHg, 24-hours later IOP of 10.93mmHg and last IOP of 20.5mmHg
Conclusions :
Ahmed valve implantation reduces immediately intraocular pressure in the majority of patients, nevertheless the maintenance of these levels and the lack of need of hypotensive drugs are in question, may the valve itself be the cause or the underlying systemic comorbidities is one of our questions. We are also comparing the results of the implantation of Ahmed valve alone with the implantation of the valve and antiangiogenic therapy before or during the surgery
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.