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Sutureless Ahmed glaucoma valve technique reduces perforation risk
PHILADELPHIA — Implanting an Ahmed glaucoma valve without suturing the plate to the sclera can reduce risk of perforation, according to a speaker at the annual Wills Eye Conference.
The novel implantation, in which the step of suturing the valve 8 mm to 10 mm posterior to the limbus is avoided and replaced with a sutureless technique was reviewed in a retrospective case study of 100 participants, Alicia Menezes, MD, said.
Surgical success was achieved in almost 78% of cases, with IOP significantly reduced and medication use halved, which is comparable to rates reported using the traditional Ahmed glaucoma valve (New World Medical) implantation technique, she said.
“Ahmed valve [implantation] typically involves suturing the anterior plate edge to the sclera about 8 to 10 mm posterior to the limbus, but it can be complicated by poor exposure, posing risk for scleral perforation. Our technique eliminates this challenging step, increasing efficiency and reducing potential risks,” Menezes said.
Complications included diplopia, dysesthesia, tube erosion, tube occlusion, tube migration and suprachoroidal hemorrhage, all at rates comparable to traditional Ahmed glaucoma valve implantation. There was one case of plate migration anteriorly, which was managed with observation. No cases of scleral perforation or related complications were reported. – by Rebecca L. Forand
Reference: Menezes, A. A novel surgical technique for Ahmed glaucoma valve implantation without plate sutures. Presented at: Wills Eye Conference; March 8 to 10, 2018; Philadelphia.
Disclosure: Menezes reports no relevant financial disclosures.