Surgical outcomes associated with a sutureless drainage valve implantation procedure in patients with refractory glaucoma
Authors Pham CN, Radcliffe NM, Vu DM
Received 4 September 2018
Accepted for publication 9 November 2018
Published 12 December 2018 Volume 2018:12 Pages 2607—2615
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Caroline N Pham,1 Nathan M Radcliffe,1–3 Daniel M Vu2
1New York University, New York, NY, USA; 2Weill Cornell Medical College, New York, NY, USA; 3New York Eye Surgery Center, New York, NY, USA
Purpose: To evaluate the safety and efficacy profile of a sutureless procedure for drainage valve implantation with combined cataract removal and/or endoscopic cyclophotocoagulation (ECP).
Materials and methods: A retrospective case series study of consecutive surgeries for Ahmed glaucoma valve (AGV; New World Medical) implantation in a 1-year period was analyzed. The surgery was performed using a Tisseel fibrin sealant (Baxter Healthcare Corporation) in place of sutures. Some subsets within the case series also included a cataract extraction with intraocular lens (CEIOL) insertion and/or ECP (Endo Optiks) within the same procedure. Primary outcomes for this study including efficacy (IOP change, reduction in medications) and safety (complications and reoperations) were measured out to 3 years. Comparisons between subsets were made using ANOVA with post hoc Tukey’s pairwise tests.
Results: One hundred twenty-two eyes of 99 patients underwent sutureless AGV implantation surgery. Of the 122, 18 had an AGV implantation only, 46 had an AGV + CEIOL, 35 had an AGV + ECP, and 23 had an AGV + CEIOL + ECP. In total, there was a significant decrease in IOP (P<0.0001) and number of glaucoma medications (P≤0.0054) at each postoperative visit. In a one-way ANOVA, there were no significant differences in mean IOP between the different subsets of surgeries (P>0.05); 10.7% and 14.8% of eyes required a reoperation either for a complication or for uncontrolled glaucoma, respectively.
Conclusion: Sutureless valve implantation is associated with a significant reduction in IOP percentage and medication use after the procedure with a safety profile comparable with other glaucoma surgeries.
Keywords: Ahmed glaucoma valve, glaucoma surgery, tube shunt surgery
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]