Abstract
Purpose :
Intraocular hypertension and glaucoma are common complications after retina surgeries with silicone tamponade. In this study we evaluated and compared the results of micropulse transscleral cyclophotocoagulation (MP-TSCPC) and Ahmed valve implantation (AV) in patients with glaucoma secondary to silicone tamponade.
Methods :
In this ambispective analytic, transverse study, we analyzed data from a 4-year period (2018 to 2022) from the glaucoma department in the ophthalmology hospital in Mexico City “Hospital Nuestra Señora de la Luz”, comparing patients with diagnosis of open angle glaucoma secondary to silicone tamponade, which were treated with either AV or MP-TSCP. IOP was measured preoperative, and postoperative at day 1, week 1, week 4, month 3, month 6 and month 12. Reduction in topical medications and visual acuity was also evaluated.
Results :
A total of 37 patients were included, 14 (37%) were treated with MP-TSCP and 23 (63%) with AV.
Patients in the AV group had a maximum and minimum IOP of 58 mmHg y 18 mmHg respectively with a mean pre-operative IOP of 33.13 mmHg. Patients treated with MP-TSCP had a mean IOP of 33.89 mmHg with a maximum of 60 mmHg and a minimum of 14mmHg.
Both groups had a statistically significant reduction in IOP, the AV group with p=0.0245 and MP-TSCP p= 0.0085.
The use of antihypertensive topical drugs pre- and postoperative, was also evaluated. Both groups had a mean of 3.5 topical drugs pre-operative and both showed a reduction that was statistically significant p=0.0001 in the AVI group and p= 0.0203 in the MP-TSCP group.
There was no statistically significant difference in visual acuity pre- and postoperative in either group.
A two-way ANOVA was used to compare mean post operative IOP in both groups, the AV group showed a greater reduction in IOP, however the difference was not statistically significant.
Conclusions :
Both procedures showed a reduction in IOP in patients with glaucoma secondary to silicone tamponade, however there was no statistically significant difference between them. Showing that the election of each intervention should be individualized for each patient.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.