Efficacy and safety of Ahmed glaucoma valve implantation with lens extraction in neovascular glaucoma with cataract

Abstract

AIM:To assess the efficacy of Ahmed glaucoma valve implantation combined with lens extraction for neovascular glaucoma(NVG)with cataract.METHODS: A retrospective comparative study was designed. 93 patients with NVG were enrolled. All patients received preoperative anti-vascular endothelial growth factor(VEGF)injections, 41 eyes underwent Ahmed glaucoma valve(AGV)implantation only, and 52 eyes underwent AGV implantation and lens extraction by phacoemusification. The best corrected visual acuities(BCVA), intraocular pressure(IOP), and surgical complications were evaluated.RESULTS: Postoperative visual acuity was improved in 16 eyes(39%), decreased in 14 eyes(34%), unchanged in 11 eyes(27%)in group 2, and 15 eyes(29%)improved,24 eyes(46%)decreased, 13 eyes(25%)unchanged in group 1 respectively(P>0.05). The group 2 demonstrated an 51% complete and 22% qualified success rate and 27% failure rate, and the 44% complete and 25% qualified success rate and 31% failure rate in group 1(P>0.05). Among the complications, fibrous exudation(56%)was the first, hyphema(46%)came second in group 2, while shallow anterior chamber(35%)was the most, fibrous exudations(31%)and anterior chamber hyphema(25%)followed in the group 1. And no tube extrusion serious complication had occurred in both groups(P<0.05). No significant differences in postoperative complications were observed between the groups(P>0.05).CONCLUSION: For NVG with cataract, AGV implantation with lens extraction is a priority for reduction of IOP and improvement of visual acuity.

Keywords

• neovascular glaucoma
• ahmed glaucoma valve implantation
• phacoemulsification
• cataract
• visual acuity
• intraocular pressure
• complication