Ahmed valves vs trabeculectomy combined with pans plana vitrectomy for neovascular glaucoma with vitreous hemorrhage

作者：Wang, Menghua H.; Li, Qiuming M.^*; Dong, Hongtao T.; Dong, Shuqian Q.; Li, Yang; Zheng, Chunyan Y.

来源：European Journal of Ophthalmology, 2017, 27(6): 774-780.

DOI：10.5301/ejo.5000973

• Ahmed glaucoma valve
• Neovascular glaucoma
• Ranibizumab
• Trabeculectomy
• Vitrectomy
• Vitreous hemorrhage

Purpose: Vitreous hemorrhage is common in advanced neovascular glaucoma (NVG), which has poor visual prognosis. This study aimed to compare the efficacy of 23-G pars planar vitrectomy (PPV) combined with either Ahmed glaucoma valve (AGV) implantation or trabeculectomy after intravitreal ranibizumab (IVR) treatment for NVG with vitreous hemorrhage.
Methods: This retrospective, nonrandomized study included 33 eyes of 33 patients with NVG with vitreous hemorrhage. After IVR treatment for 3-7 days, 18 eyes underwent PPV + AGV (AGV group) and 15 underwent PPV + trabeculectomy (trabeculectomy group). The success criterion was a postoperative intraocular pressure (IOP) of 6-21 mm Hg, with or without antiglaucoma medication.
Results: Postoperative IOP decreased significantly in both groups, but the mean IOP after 12 months was significantly lower in the AGV group (16.92 +/- 2.75 mm Hg) than the trabeculectomy group (21.50 +/- 5.79 mm Hg; p = 0.018). The AGV group required fewer glaucoma medications than the trabeculectomy group. The cumulative probabilities of surgical success rates for the AGV and trabeculectomy groups at 12 months were 71.3% and 46.7%, respectively. No significant differences in postoperative complications were observed between the groups.
Conclusions: For NVG with vitreous hemorrhage, PPV with AGV implantation may reduce IOP more effectively than PPV with trabeculectomy.

• 出版日期2017-12
• 单位郑州大学