Surgical results of Ahmed valve implantation combined with intravitreal triamcinolone acetonide injection for preventing choroidal detachment

The Relationship between Serous Choroidal Detachment and the Ahmed Glaucoma Valve Failure

Purpose

To investigate the effect of serous choroidal detachment (SCD) on the success of Ahmed glaucoma valve (AGV) implantation.

Methods

Patients who underwent AGV implantation and developed SCD were included in the case group. The control group was matched based on age, sex, baseline intraocular pressure (IOP), glaucoma type, and the number of glaucoma medications. The patient data were retrospectively extracted from available records. The primary outcome measure was an AGV success rate based on 5 < IOP <18 and a 20% reduction from baseline.

Results

Seventeen patients were enrolled in the case group and 38 in the control group. Preoperative visual acuity of patients was 1.17 ± 0.43 and 1.16 ± 0.37 logMAR in the case and control groups, respectively. The patients in the case group showed higher mean IOP at all time intervals compared to controls. However, the mean IOP only reached a statistically significant difference at 3 months (17.94 ± 6.78 mmHg vs. 13.39 ± 3.09 mmHg, P = 0.003). The mean survival duration was significantly shorter in patients with SCD (10.4 ± 0.7 months vs. 11.7 ± 0.2 months for controls log-rank = 4.1, P = 0.04). The cumulative probability of success was 76.5% in patients with SCD and 94.7% in the control group after 12 months.

Conclusions

SCD after AGV implantation could be a risk factor for failure. A larger prospective study with a longer follow-up duration is required to confirm the present study results.

Subtenon triamcinolone injection to treat serous choroidal detachment after glaucoma surgery: A case series

PURPOSE

To report the effect of subtenon triamcinolone acetonide (TA) injection in the treatment of serous choroidal detachment (SCD) after glaucoma surgery.

METHODS

In this prospective case series, patients with persistent, non-resolving, or progressive SCD after glaucoma surgery were enrolled. For those with non-resolving or progressive SCD despite of using systemic corticosteroids, topical atropine and topical steroids, one milliliter of TA (40mg/mL) was injected inferotemporally into the posterior subtenon space.

RESULTS

Sixteen consecutive patients with a mean ± SD age of 70.12 ± 11.12 years were included in this study. After injection of subtenon TA, SCD was completely resolved after 1 to 4 weeks, with deepening of the anterior chamber in all cases. All cases were followed for at least 6 months after the injection with no signs of recurrence.

CONCLUSION

Subtenon injection of TA is a safe and effective modality of treatment for resolving a persistent or progressive SCD after glaucoma surgeries.