AZƏRBAYCANDA REFRAKTER QLAUKOMA ZAMANI AHMED QLAUKOMA DRENAJI İMPLANTASİYASININ UZAQ NƏTİCƏLƏRİ

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SUMMARY

Aim - to assess the safety and effcacy of Ahmed glaucoma valve (AGV) implantation in patients with refractory glaucoma for a long time.

Material and methods
Fifty-seven eyes of ffty-one patients who underwent Ahmed glaucoma valve implantation were included in the study. All patients were followed for 60 months. Visual acuity, changes of intraocular pressure (IOP), use of glaucoma medications, incidence of complications and postsurgical interventions were examined.

Results
The IOP decreased from a mean of preoperative value of 35.35 ± 9.5 mmHg (17-60) on a mean of 2.17 ± 0.5 (1-4) glaucoma medications to 20.1 ± 4.6 mmHg (8.7-37.2) on a mean of 1.74 ± 1.14 (0-3) glaucoma medications, respectively, in 60 months. The mean preoperative visual acuity increased from 0.08 ± 0.13 (0-0.9) to 0.13 ± 0.19 (0-0.9) at the fnal examination. The most frequent early postoperative complications were hyphema (6 eyes, 10.5%), shallow anterior chamber (3 eyes, 5,3%), infammation (2 eyes, 3.5%), hypertension (3 eyes, 5,3%), choroidal effusion (4 eyes, 7%), exudative retinal detachment (1 eye, 1.75%), late postoperative complications included occlusion (1 eye, 1.75%) , reposition (2 eyes, 3.5%) and exposition (1 eye, 1.75%) of the tube, and encapsulation of the plate (2 eye, 3.5%) of the AGV. The use of glaucoma drops was resumed at 3, 6, 12, 24, 36, 48, 60 months at 3 (5.3%), 11 (19.3%), 15 (26%), 32 (56%), 38 (66.7%), 42 (73.7%), 45 (78.9%) eyes, respectively.

Conclusion
AGV implantation in eyes with refractory glaucoma led to a signifcant IOP reduction in early period with minimal risk of postoperative complications. However, in the late period, in 80% of cases due to excessive plate encapsulation, the functionality of AGV decreases. The implantation of AGV would be more suitable for patients who require an immediate reduction in IOP after surgery.