Outcomes of intraluminal stenting and external ligation of Ahmed Glaucoma Valve (AGV) in management of refractory glaucoma and prevention of postoperative hypotony
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First Author: F.Wagdy EGYPT
To describe the efficacy of Combined subscleral trabeculectomy and Express Shunt in Refractory glaucoma.
Stenting- ligation- Ahmed valve- Hypotony Setting. Menofia university hospital , Egypt
This prospective randomized study included 30 eyes of 25 patients with refractory glaucoma aged beween 44 years old and 56 years old that were dignosed as refractory glaucoma. This study was done in Mansoura University and Menofia University Hospitals in the period between September 2018 and January 2020 .The studied eyes were divided into two groups the first group was subjected to Ahmed valve implantation with intraluminal stenting and the second group was subjected to Ahmed valve with external ligation .All patients were followed up to one year after the surgery .
There were significant reduction in IOP in both groups with more reduction in intraluminal stenting group where mean IOP after one year was 11.67±0.899 While in external ligation group the mean IOP was 14.2±4.00mmgh ( p value = 0.02) however the difference between the 2 groups in lowering IOP was insignificant. As regarding postoperative complications, Postoperative hypotony was more in external ligation group that occurred in 2 cases (13.33%) %) while in the intraluminal stenting group the hypotony occurred only in 1 case (6.67%%).Also Both groups were represented with stability as regarding visual acuity and visual field.
Intraluminal stenting and external ligation when applied with AGV surgery usually prevent the postoperative hypotony (transient and persistent) that may be occurred in the conventional AGV surgery.