title: Pars plana Ahmed implantation combined with 23-gauge vitrectomy for refractory neovascular glaucoma in diabetic retinopathy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of a pars plana Ahmed valve implantation combined with 23-gauge sutureless vitrectomy in the treatment of patients with medically uncontrolled neovascular glaucoma (NVG) in proliferative diabetic retinopathy (PDR).
  
  
  METHODS
  The authors retrospectively reviewed the records of 11 consecutive patients with refractory NVG in PDR who underwent a 23-gauge sutureless vitrectomy combined with pars plana placement of an Ahmed valve implant. Control of intraocular pressure (IOP), pre- and postoperative best-corrected visual acuity and the development of intra- and postoperative complications were evaluated during the follow-up.
  
  
  RESULTS
  The mean follow-up was 12.2 months (range, 8 to 25 months). Mean preoperative IOP was 35.9 ± 6.3 mmHg and mean postoperative IOP at the last visit was 13.3 ± 3.2 mmHg. Control of IOP (8 to 18 mmHg) was achieved in all patients, but 91% (10 of 11 patients) needed antiglaucoma medication (mean number of medications, 1.2 ± 0.6). Postoperative visual acuity improved in 11 eyes, and the logarithmically to the minimum angle of resolution mean visual acuity in these eyes improved from 1.67 ± 0.61 to 0.96 ± 0.67. The complications that occurred were transient hypotony in one case, transitory hypertension in two cases, and postoperative vitreous hemorrhage which spontaneously cleared in two cases.
  
  
  CONCLUSIONS
  We suggest the combination of 23-gauge pars plana vitrectomy and Ahmed valve implantation is safe and effective in PDR patients with refractory NVG.
authors.affiliation: Department of Ophthalmology, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Hoon Seok
authors.initials: HS
authors.lastname: Jeong
authors.forename: Dong Heun
authors.initials: DH
authors.lastname: Nam
authors.forename: Hae Jung
authors.initials: HJ
authors.lastname: Paik
authors.forename: Dae Yeong
authors.initials: DY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000150:complications* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*