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Safety and efficacy of paediatric silicone Ahmed glaucoma valve (AGV) in adult eyes with post-VR surgery glaucoma
Eye ( IF 2.8 ) Pub Date : 2019-11-04 , DOI: 10.1038/s41433-019-0663-0
Kiranmaye Turaga 1 , Aparna Rao 2 , Mohammed Hasnat Ali 3 , Ramyashri Shastry 4 , Nikhil Choudhari 4 , Chandrasekhar Garudadri 4 , Sirisha Senthil 4
Affiliation  

Purpose To compare the safety and efficacy of the FP8 AGV (paediatric) with the standard FP7 AGV in adult post-vitreoretinal (VR) surgery glaucoma. Methods We included 45 consecutive eyes with post-VR surgery glaucoma implanted with either FP8 ( n = 28) or FP7 ( n = 17) AGV between 2008 and 2016. The data analysed included visual acuity (VA), intraocular pressure (IOP), complications, interventions, and outcomes. Results Mean age ( p = 0.24), mean baseline VA ( p = 0.77), preoperative IOP ( p = 0.41), number of antiglaucoma medications ( p = 0.92), and previous surgeries ( p = 0.16) were comparable in the two groups. The number of eyes with previous belt buckle was significantly higher ( p < 0.001) in the FP8 group (17/28) compared with the FP7 group (2/17), indicating space constraint and scarred conjunctiva. The median follow-up (25th, 75th percentile) was 14.7 (9.1, 25.3) months in the FP7 and 9.8 (6.4, 34.7) months in the FP8 groups ( p = 0.62). Postoperatively, the median VA ( p = 0.24), the mean IOP at final follow-up ( p = 0.15), and median number of AGM ( p = 0.99) were comparable in both the groups. The median percentage drop in IOP (95% confidence interval) with the FP7 implant was 55% (43.70%) and with FP8 implant was 53.8% (25, 73), ( p = 0.20). None in the FP7 group failed, while three eyes in the FP8 group failed. During the study period, two eyes in the FP8 group had tube exposure that was surgically managed. None of the eyes had implant exposure or loss of light perception. Conclusion Use of the paediatric FP8 AGV in adult post-VR surgery glaucoma eyes with severe conjunctival scarring and limited subconjunctival space resulted in reasonable IOP control compared with the standard FP7 AGV implant. There were no eyes with implant extrusion.

中文翻译:

儿童硅胶 Ahmed 青光眼瓣膜 (AGV) 在 VR 术后青光眼成人眼中的安全性和有效性

目的 比较 FP8 AGV(儿科)与标准 FP7 AGV 在成人玻璃体视网膜术后(VR)手术青光眼中的安全性和有效性。方法 我们纳入了 2008 年至 2016 年间植入 FP8 (n = 28) 或 FP7 (n = 17) AGV 的 45 只 VR 术后青光眼连续眼。 分析的数据包括视力 (VA)、眼压 (IOP)、并发症、干预和结果。结果 两组的平均年龄 (p = 0.24)、平均基线 VA (p = 0.77)、术前 IOP (p = 0.41)、抗青光眼药物的数量 (p = 0.92) 和既往手术 (p = 0.16) 具有可比性. 与 FP7 组 (2/17) 相比,FP8 组 (17/28) 中先前系过皮带扣的眼睛数量显着增加 (p < 0.001),表明空间受限和结膜瘢痕。中位随访(第 25 天,第 75 个百分位数)在 FP7 组中为 14.7 (9.1, 25.3) 个月,在 FP8 组中为 9.8 (6.4, 34.7) 个月(p = 0.62)。术后,两组的中位 VA (p = 0.24)、最终随访时的平均眼压 (p = 0.15) 和 AGM 中位数 (p = 0.99) 具有可比性。FP7 种植体的 IOP 中位数下降百分比(95% 置信区间)为 55% (43.70%),FP8 种植体为 53.8% (25, 73),( p = 0.20)。FP7 组中没有一只眼睛失败,而 FP8 组中的 3 只眼睛失败了。在研究期间,FP8 组的两只眼睛进行了手术治疗。没有一只眼睛有植入物暴露或光感丧失。结论 与标准 FP7 AGV 植入物相比,在具有严重结膜瘢痕和结膜下空间有限的成人 VR 术后青光眼眼中使用儿科 FP8 AGV 可实现合理的 IOP 控制。没有植入物挤出的眼睛。
更新日期:2019-11-04
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