Pars plana Ahmed valve implant and vitrectomy in the management of neovascular glaucoma.
To evaluate the efficacy and safety of the pars plana Ahmed glaucoma valve (New World Medical, Inc., Rancho Cucamonga, CA) implant combined with pars plana vitrectomy and panretinal photocoagulation for the management of neovascular glaucoma in patients with vitreous hemorrhage.



The records of 18 eyes of 17 consecutive patients with neovascular glaucoma who had undergone pars plana vitrectomy and pars plana Ahmed valve implant were evaluated. The patients were observed for a mean time of 14.2 months (range, 6 to 28 months).



Mean preoperative intraocular pressure with oral and two or three topical antiglaucoma medications was 53.3 +/- 10 mm Hg, and mean postoperative intraocular pressure without oral antiglaucoma medications was 16.3 +/- 7.1 mm Hg (P < .0001) at the final visit. Overall success rate was 72.2%, defined as an intraocular pressure of 5 to 21 mm Hg with or without antiglaucoma medication. A postoperative hypertensive phase occurred in 7 patients (38.8%), of which all but one responded to medical therapy. Visual acuity was stabilized or improved in 77.7% of the eyes. There was one case of each of the following adverse events: mild vitreous cavity hemorrhage, hypotony, choroidal effusion, epiretinal membrane, corneal edema, and corneal ulcer. Two cases developed phthisis bulbi and lost light perception.



Pars plana vitrectomy and Ahmed valve implantation seems to be a viable surgical modality in the management of neovascular glaucoma and coexisting posterior segment pathology with a relatively low rate of serious permanent postoperative complications.
Faghihi
Hooshang
H
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Hajizadeh
Fedra
F
Mohammadi
Seyed-Farzad
SF
Kadkhoda
Arezoo
A
Peyman
Gholam A
GA
Riazi-Esfahani
Mohammad
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000150:complications / Q000601:surgery*