July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Ahmed valve implantation for secondary glaucoma in elderly uveitis patients
Author Affiliations & Notes
  • Nils Steinhorst Steinhorst
    Ophthalmology, Universityhospital Hamburg, Hamburg, Hamburg, Germany
  • Maria Katharina Casagrande
    Ophthalmology, Universityhospital Hamburg, Hamburg, Hamburg, Germany
  • Martin Spitzer
    Ophthalmology, Universityhospital Hamburg, Hamburg, Hamburg, Germany
  • Nicole Stuebiger
    Ophthalmology, Universityhospital Hamburg, Hamburg, Hamburg, Germany
  • Footnotes
    Commercial Relationships   Nils Steinhorst, None; Maria Casagrande, None; Martin Spitzer, None; Nicole Stuebiger, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6642. doi:
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      Nils Steinhorst Steinhorst, Maria Katharina Casagrande, Martin Spitzer, Nicole Stuebiger; Ahmed valve implantation for secondary glaucoma in elderly uveitis patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6642.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the outcome of Ahmed glaucoma valve (AGV) implant on elevated intraocular pressure (IOP) in elderly uveitis patients.

Methods : This retrospective study evaluates the data of 6 eyes of 6 caucasian patients with uveitis and secondary glaucoma. Success was defined as an IOP between 6-21 mmHg without (complete) or with (qualified) IOP lowering medication and without further need for glaucoma surgery/tube extraction. Follow up was performed after 1 day, 3, 6, and 12 months. Origin of uveitis was viral in 3 cases, uveitis-glaucoma-hyphaema syndrome in 1 and 1 was unknown. According to the Sun Criteria 1 patient was inactive and 5 patients displayed improved activity.

Results : Mean age of the patients was 63 ± 8.4 years at implantation. All patients had previous glaucoma surgery. Mean preoperative IOP was 33.3 ± 9.6 mmHg. After 6 months mean IOP was 12 ± 4,6 mmHg (p<0.001) and after 12 months 19 ± 11.4 mmHg (p=0.04). IOP lowering agents decreased from mean 4 active agents to 0.3 after 12 months (p<0.001). Complete success was achieved in 2 patients, qualified success in 3 patients. One eye was considered a failure due to tube removal. Visual acuity was stable in all patients. Uveitis activity worsened in 5 patients early postoperative, but improved to inactive again after 12 months. Early postoperative complications were seen in all patients predominately early hypotony. One patient developed a macular edema after 3 months, which dissolved after injection with triamcinolone acetonide.

Conclusions : AGV implantation is effective in managing secondary glaucoma in elderly uveitis patients. Early complications are frequent especially hypotony. A uveitis relapse is common in particular early postoperatively.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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