title: Disorder of blood-aqueous barrier following Ahmed Glaucoma Valve implantation.
abstract: BACKGROUND
  Ahmed Glaucoma Valve implantation (AGVI) is used to treat refractory glaucoma. Breakdown of the blood-aqueous barrier (BAB) has been noted after some surgical techniques. The current study was designed to assess BAB disruption after AGVI.
  
  
  METHODS
  Anterior chamber protein content was measured by the laser flare cell photometry in 22 eyes of 22 patients with refractory glaucoma before AGVI and at each postoperative visit up to 1 month.
  
  
  RESULTS
  Before AGVI the mean aqueous flare values in all eyes were (15.17 ± 9.84) photon counts/ms. After AGVI, the values significantly increased at day 1, day 3, and week 1 compared to those before AGVI (all P < 0.05) with a peak at day 3. They returned to pre-operative levels at week 2, and were lower than preoperative level at month 1. Eyes with previous intraocular surgery history had greater aqueous flare values than those without previous intraocular surgery history, but there were no significant differences at all time points postoperatively (all P > 0.05). Furthermore, eyes with shallow anterior chambers had greater aqueous flare values at day 3 and week 1 (all P < 0.05). When comparing eyes with other refractory glaucoma conditions, neovascular glaucoma combined with intravitreal bevacizumab injection resulted in lower aqueous flare values after AGVI, but no significant differences were observed at all time points, postoperatively (all P > 0.05).
  
  
  CONCLUSIONS
  The BAB was impaired and inflammation was present in the anterior chamber in refractory glaucomatous eyes following AGVI. However, such conditions were resolved within 1 month postoperatively. Intravitreal bevacizumab treatment in neovascular glaucoma eyes before AGVI may prevent BAB breakdown.
authors.affiliation: Department of Glaucoma, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, Guangdong 520275, China.
authors.forename: Min-Wen
authors.initials: MW
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Shi-da
authors.initials: SD
authors.lastname: Chen
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Huang
authors.forename: Xiu-Lan
authors.initials: XL
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001082:Aqueous Humor / Q000502:physiology; D018916:Blood-Aqueous Barrier / Q000473:pathology*; D005260:Female; D020327:Glaucoma Drainage Implants / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies