Clinical Ophthalmology (Mar 2017)
The efficacy of Alahmady ring implantation in the management of neovascular glaucoma
Abstract
Alahmady H Alsmman, Gamal Radwan, Mohammed Elagouz, Usama Ali Mohammed The Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt Purpose: To evaluate the efficacy and safety of Alahmady ring implantation in the management of neovascular glaucoma.Methods: A total of 15 eyes of 15 patients with intractable neovascular glaucoma with intraocular pressure (IOP) ≥28 mmHg not responding to medical treatment were retrospectively analyzed. All patients had poor visual acuity and underwent Alahmady ring implantation. The ring was designed from fenestrated silicon tube used in lacrimal surgeries and was implanted subsclerally after passing it through the anterior chamber. Patients were followed up for at least 24 months. Success in this study was defined based on IOP ≥8 mmHg and <21 mmHg, with not more than 1 glaucoma drug, and improvement of patient symptoms and signs with maximum use of beta blocker as antiglaucoma drug.Results: A total of 15 eyes of 15 patients (9 males [60%] and 6 females [40%]) were analyzed in this study. The mean IOP before surgery was 38.6 mmHg (standard deviation [SD]: 6.98) and it was 14.05 mmHg (SD =7.57) after surgery. The follow-up range was 24–36 months. Success of silicon drainage device was defined as an IOP <21 mmHg on the last follow-up visit. Medications included only beta-blockers and topical steroids for those who were without severe complications or for those who were not in a condition to undergo a further glaucoma surgery.Conclusion: Alahmady ring implantation proves to be a good surgical option for neovascular glaucoma; however, a longer follow-up period is recommended. Keywords: refractory glaucoma, glaucoma device, failed trabeculectomy
