Ahmed Valve Implant Surgery with Adjunctive Mitomycin C and Selective 5-Fluorouracil Injection.
10.3341/jkos.2016.57.3.468
- Author:
Il Suk YUN
1
;
Jung Dong LEE
;
Yong Hyun KIM
;
Jae Hong AHN
Author Information
1. Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea. chrisahn@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
Ahmed valve implant;
5-Fluorouracil;
Mitomycin C;
Needling;
Refractory glaucoma
- MeSH:
Fluorouracil*;
Follow-Up Studies;
Glaucoma;
Humans;
Intraocular Pressure;
Mitomycin*;
Retrospective Studies;
Risk Factors
- From:Journal of the Korean Ophthalmological Society
2016;57(3):468-476
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the surgical results of Ahmed valve implant surgery with adjunctive mitomycin C and selective postoperative 5-fluorouracil (5-FU) subconjunctival injection with a needling procedure. METHODS: In this retrospective study, 40 eyes of 40 patients who had undergone Ahmed valve implant surgery with adjunctive mitomycin C were observed for at least 1 year. The Ahmed valve was implanted after 5-minute application of 0.04% mitomycin C. Selective 5-FU injection with a needling procedure was performed during the follow- up period based on intraocular pressure (IOP). Hypertensive phase was defined as IOP higher than 21 mm Hg within 3 months after operation. IOP higher than 18 mm Hg regardless of IOP-lowering medications at 2 consecutive visits was considered to be a surgical failure. RESULTS: The mean follow-up period was 35.5 ± 12.4 months. Preoperative intraocular pressure was 32.8 ± 7.5 mm Hg, which decreased to 14.0 ± 4.2 mm Hg post-operatively. The number of glaucoma medications decreased significantly from 3.8 ± 0.5 to 2.0 ± 1.0. Eleven of 40 eyes (27.5%) experienced hypertensive phase at 6.0 ± 3.1 weeks after surgery. Kaplan-Meier survival analysis showed cumulative probability of surgical success rates of 82.5%, 79.6%, 72.7%, and 58.8% at 1, 2, 3, and 4 postoperative years respectively. There were no risk factors that affecting surgical failure except age (hazard ratio = 0.17, p = 0.02). CONCLUSIONS: Ahmed valve implant surgery with adjunctive mitomycin C and selective 5-FU injection with a needling procedure showed good success in refractory glaucoma.
