Excisional Bleb Revision for Management of Failed Ahmed Glaucoma Valve Publisher Pubmed



Eslami Y¹ ; Fakhraie G¹ ; Moghimi S¹ ; Zarei R¹ ; Mohammadi M¹ ; Nabavi A¹ ; Yaseri M¹ ; Izadi A¹ Show Affiliations
Source: Journal of Glaucoma Published:2017

Abstract

Purpose: To evaluate the outcome of excisonal bleb revision in patients with failed Ahmed glaucoma valve (AGV). Patients and Methods: In total, 29 patients with uncontrolled intraocular pressure (IOP) despite of maximal tolerated medical therapy at least 6 months after AGV implantation were enrolled in this prospective interventional case series. Excision of fibrotic tissue around the reservoir with application of mitomycin C 0.02% was performed. IOP, number of glaucoma medications were evaluated at baseline and 1 week and 1, 3, 6, and 12 months postoperatively. Complete and qualified success was defined as IOP≤21 mm Hg with or without glaucoma medications, respectively. Intraoperative and postopervative complications were also recorded. Results: Mean IOP was reduced from 30±4.2 mm Hg at baseline to 19.2±3.1 mm Hg at 12-month follow-up visit (P<0.001). Average number of glaucoma medications was decrease from 3.2±0.5 at baseline to 1.9±0.7 at 12-month follow-up (P<0.001). Qualified and complete success rates at 12-month follow-up were 65.5% and 6.9%, respectively. Younger age and higher number of previous glaucoma surgeries were significantly associated with the failure of excisonal bleb revision. Conclusion: Excisional bleb revision could be considered as a relatively effective alternative option for management of inadequate IOP control after AGV implantation. © 2017 Wolters Kluwer Health, Inc. All rights reserved.