Abstract:

To evaluate the efficacy of the long term results of Ahmed glaucoma valve(AGV) implantation at refractory glaucoma cases on intraocular pressure, visual acuity and cornea. The cases AGV implanted with refractory glaucoma were evaluated retrospectively between the years 2003 to 2014. The cases were selected at least light perception visual acuity and followed longer than 12 months. Preoperative and postoperative corrected distance visual acuity levels(CDVA), intraocular pressure(IOP), number of medication and central corneal thickness(CCT) were recorded. Complications and additional surgeries were noted. The perfect achievement were considered as the combination of; no additional surgery necessity, achieved mean IOP level between 5-22 mmHg, stability of visual acuity and corneal transparency. Forty eight eyes of 47 refractory glaucoma cases with neovascular(n=13), aphacic(n=13), secondary to penetrating keratoplasty(PK)(n=7), congenital(n=4), traumatic(n=5) and primer refractory glaucoma(n=6). Mean age was 50.40±22.80 years, mean follow up was 32.33±20.78(12-84) months, preoperative and postoperative CDVA were respectively 1.50±0.61 and 1.60±0.57 LogMAR, IOP values were 39.22±9.47 and 17.02±4.29 mmHg, number of medication were 3.47±0.92 and 1.52±1.09, CCT were 590.00±88.86 and 655.25 ±170.88µm.(p<0.05) Additional surgeries were suprachoroidal hemorhage drainage(n=1), AGV tip cleaning(n=5), anterior vitrectomy(n=5), AGV reposition(n=3), AGV tip shorthening(n=6), corneal greft insufficieny related PK(n=3), additional cyclodestructive procedures(n=5). Perfect surgical, total surgical success and unsucceful surgical rates were detected as %46(n=22), %89.4(n=43) and %10.6(n=5) respectively. AGV was a considerable succesfull surgical option for decreasing the IOP in refractory glaucoma cases. However even there is not a significant AGV endothelial touch, endothelial insufficiency related corneal edema and eventual visual loss was seen.

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