Modified valve implantation may be effective for advanced glaucoma

Pars plana vitrectomy followed by Ahmed valve implantation was effective in controlling IOP in patients with advanced glaucoma, according to a study.

Torsten Schlote and colleagues at the University of Tübingen in Germany enrolled 11 eyes of nine patients in a prospective, interventional case series to determine the safety and efficacy of pars-plana-modified Ahmed glaucoma valve implantation in eyes with advanced secondary glaucoma. Eyes included in the study had aphakic, neovascular, traumatic, inflammatory or pseudoexfoliation glaucoma. All patients underwent pars plana vitrectomy before tube insertion.

Ten of 11 eyes had controlled IOP at 1 year after surgery; seven eyes did not need medical therapy. The average IOP decreased from 32.2 mm Hg before surgery to 15.7 mm Hg postoperatively. The average number of medications decreased from 2.9 to 0.5. Complications included transient hypotony, transient choroidal effusion and an intermediate increase in IOP.

The researchers noted that the modified technique requires a partial ligature of the tube to prevent early hypotony, and close follow-up is needed to monitor variation of IOP during the first year after surgery.

The series is published in the March issue of Graefe’s Archive for Clinical and Experimental Ophthalmology.