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Combination surgery lowers IOP, reduces need for medications
In patients with late IOL dislocation and elevated IOP, transscleral IOL fixation combined with an Ahmed glaucoma drainage device decreased pressure and reduced the number of glaucoma medications needed, according to a study.
The retrospective study consisted of 11 eyes of 11 patients with pseudoexfoliation glaucoma, high IOP and late IOL dislocation who underwent transscleral IOL fixation combined with implantation of an Ahmed glaucoma drainage device (New World Medical).
Median IOP at baseline was 33 mm Hg. Median IOP at the final follow-up of 1.75 years was 13 mm Hg (P < .01). The number of glaucoma medications used by patients decreased from three to two at final follow-up (P = .03).
Additionally, patients experienced an average best corrected visual acuity improvement from 0.77 logMAR at baseline to 0.44 logMAR at final follow-up; the improvement was not statistically significant, however.
“Despite the fact that the postoperative BCVA was equal or better than the preoperative BCVA in 10 of 11 patients, there was no statistically significant improvement in BCVA with surgery. This lack of significant visual improvement despite successful centering [of] the dislocated IOL is likely due to the small sample size and the fact that five patients had poor visual prognosis preoperatively, secondary to end-stage glaucoma (three patients) and macular degeneration (two patients), limiting their potential for visual recovery after surgery,” the researchers wrote.
Surgical complications were observed in four eyes. – by Robert Linnehan
Disclosures: Torres reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.