PURPOSE: To evaluate the outcome of Ahmed valve implantation as a primary or secondary glaucoma surgery to treat refractory glaucoma patients. METHODS: A total of 101 eyes of 101 patients with refractory glaucoma, who received Ahmed valve implantation between March 1995 to September 2004 were included. We divided cases into primary surgery group, who had no trabeculectomy, and secondary surgery group, who had trabeculectomy before Ahmed valve implantation. Successful operation was defined as having the following outcomes: (1) postoperative intraocular pressure (IOP) sustained between 5 and 21mmHg and reduced 30% from the baseline IOP with or without medication, (2) no visual decline due to IOP or complications, and (3) no additional filtering surgery. Clinical records were reviewed, and IOP, antiglaucoma medications, and complications were recorded. Kaplan-Meier survival analysis was used to calculate the overall probability of success. RESULTS: In primary surgery group, overall success rate was 57.6%, 46.7%, 39.7%, and 39.7% at 1, 3, 5, and 7 years, respectively. In secondary surgery group, overall success rate was 67.8%, 58.1%, 52.4%, and 43.5% at the same time points. There was, however, no statistical difference in success rates between two groups. The incidence of complications were as follows: 4.2% of endophthalmitis, 4.2% of valve exposure, 4.2% of hypotony was found in the primary surgery, and 3.8% of endophthalmitis, 1.9% of valve exposure, 9.4% of hypotony were found in the secondary surgery. There were no statistical differences in the incidences of complications between the two groups. CONCLUSIONS: Ahmed valve implantation was effective for IOP control in refractory glaucoma patients. Success rate did not show significant difference between primary and secondary Ahmed valve implantation group.
Endophthalmitis ; Filtering Surgery ; Glaucoma* ; Humans ; Incidence ; Intraocular Pressure ; Trabeculectomy

PURPOSE: To evaluate the relationship between optic disc and retinal nerve fiber layer (RNFL) measurements obtained with the optical coherence tomography (OCT) and the Heidelberg retina topography (HRT) in normal, normal tension glaucoma (NTG), and high tension glaucoma (HTG). METHODS: Normal, NTG and HTG subjects who met inclusion and exclusion criteria were evaluated retrospectively. One hundred seventy eyes of 170 patients (30 normal, 40 NTG, and 100 HTG) were enrolled. Complete ophthalmologic examination, HRT, OCT, and automated perimetry were evaluated. RESULTS: Disc area, cup area and cup/disc area ratio measured with HRT were significantly different between NTG and HTG (all p<0.05). Mean RNFL thickness measured by OCT with ascanning diameter of 3.4 mm was larger in NTG than HTG (84.97+/-24.20 micrometer vs. 73.53+/-27.17 micrometer, p=0.037). Four quadrant RNFL thickness measurements were not significantly different between NTG and HTG (all p>0.05). Mean deviation and corrected pattern standard deviation measured by automated perimetry was significantly correlated with mean and inferior RNFL thickness in both NTG and HTG (Pearson's r, p<0.05). Mean RNFL thickness/disc area ratio was significantly larger in HTG than NTG (35.21+/-18.92 vs. 31.30+/-10.91, p=0.004). CONCLUSIONS: These findings suggest that optic disc and RNFL damage pattern in NTG may be different from those of HTG.
Adult ; Aged ; Axons/*pathology ; *Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma, Open-Angle/*diagnosis ; Humans ; Male ; Middle Aged ; Ocular Hypertension/diagnosis ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Perimetry ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; *Tomography, Optical Coherence ; Visual Fields

Purpose: Renal tumors account for approximately 7% of all childhood cancers. These include Wilms tumor (WT), clear cell sarcoma of the kidney (CCSK), malignant rhabdoid tumor of the kidney (MRTK), renal cell carcinoma (RCC), congenital mesoblastic nephroma (CMN) and other rare tumors. We investigated the epidemiology of pediatric renal tumors in Korea. Materials and Methods: From January 2001 to December 2015, data of pediatric patients (0–18 years) newly-diagnosed with renal tumors at 26 hospitals were retrospectively analyzed. Results: Among 439 patients (male, 240), the most common tumor was WT (n=342, 77.9%), followed by RCC (n=36, 8.2%), CCSK (n=24, 5.5%), MRTK (n=16, 3.6%), CMN (n=12, 2.7%), and others (n=9, 2.1%). Median age at diagnosis was 27.1 months (range 0-225.5) and median follow-up duration was 88.5 months (range 0-211.6). Overall, 32 patients died, of whom 17, 11, 1, and 3 died of relapse, progressive disease, second malignant neoplasm, and treatment-related mortality. Five-year overall survival and event free survival were 97.2% and 84.8% in WT, 90.6% and 82.1% in RCC, 81.1% and 63.6% in CCSK, 60.3% and 56.2% in MRTK, and 100% and 91.7% in CMN, respectively (p < 0.001). Conclusion The pediatric renal tumor types in Korea are similar to those previously reported in other countries. WT accounted for a large proportion and survival was excellent. Non-Wilms renal tumors included a variety of tumors and showed inferior outcome, especially MRTK. Further efforts are necessary to optimize the treatment and analyze the genetic characteristics of pediatric renal tumors in Korea.