Abstract:
PURPOSE:To evaluate long-term outcomes after Ahmed valve implantation in patients with glaucoma when using adjunctive intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU). DESIGN:Retrospective, interventional, consecutive case series. METHODS:A consecutive series of eyes undergoing Ahmed valve implantation, either alone (AHMED eyes) or in combination with cataract surgery (AHMED+PHACO), using both intraoperative MMC and postoperative 5-FU were evaluated. Failure was defined as the first occurrence of any of the following: 1) the first of three consecutive visits where intraocular pressure (IOP) was >18 mm Hg or <20% IOP reduction from baseline and the final number of topical medications was not reduced by at least two from baseline, 2) the need for additional surgery, or 3) the development of serious complications. RESULTS:A total of 130 eyes underwent Ahmed valve implantation with intraoperative exposure to 0.5 mg/ml MMC (median time: eight minutes; range, four to 10) and postoperative subconjunctival injections of 5 mg of 5-FU (median: five injections; range, zero to nine). Kaplan-Meier estimates of the cumulative probability of valve success and confidence interval (CI) at the sixth follow-up year were 0.72 (95% CI, 0.59 to 0.82) for AHMED eyes (n = 88), 0.84 (95% CI, 0.65 to 0.93) for AHMED+PHACO eyes (n = 42). A median of two fewer medications were required relative to baseline for both AHMED and AHMED+PHACO eyes. CONCLUSIONS:The adjunctive use of both intraoperative MMC and postoperative 5-FU with Ahmed valve implantation results in high success rates. IOP was well controlled in the majority of patients within the six-year postoperative period.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Alvarado JA,Hollander DA,Juster RP,Lee LCdoi
10.1016/j.ajo.2008.04.008subject
Has Abstractpub_date
2008-08-01 00:00:00pages
276-284issue
2eissn
0002-9394issn
1879-1891pii
S0002-9394(08)00277-8journal_volume
146pub_type
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