Long-Term Outcomes by Tube Position After Combined Ahmed Valve Implantation and Vitrectomy in Neovascular Glaucoma
10.3341/jkos.2025.66.12.468
- Author:
Chang Min CHA
1
;
Ju Seouk LEE
;
Chang Zoo KIM
;
Seung Uk LEE
;
Sang Joon LEE
Author Information
1. Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea
- Publication Type:Original Article
- From:Journal of the Korean Ophthalmological Society
2025;66(12):468-477
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose:We evaluated the 3-year clinical outcomes of simultaneous Ahmed valve implantation and vitrectomy in patients with neovascular glaucoma.
Methods:We retrospectively reviewed 38 eyes that underwent combined Ahmed valve implantation and vitrectomy. Best-corrected visual acuity, intraocular pressure (IOP), and the number of IOP-lowering medications were assessed preoperatively and up to 36 months postoperatively. Patients were categorized into two groups (anterior chamber and vitreous cavity) based on the site of Ahmed valve tube insertion. Clinical outcomes were compared between the two groups. Surgical success was defined as maintaining IOP between 6 and 21 mmHg, with or without topical IOP-lowering medications. Surgical failure was defined as IOP outside this range despite IOP-lowering therapy, loss of vision to no light perception, or the need for valve replacement or additional Ahmed valve implantation.
Results:The overall surgical success rate was 68.4%; rates were 58.8% in the anterior chamber group and 76.2% in the vitreous cavity group. The mean durations of target IOP maintenance were 24.91 ± 3.45 months in the anterior chamber group and 29.00 ± 2.89 months in the vitreous cavity group, with no significant difference between groups (p > 0.05). Changes in visual acuity before and after surgery did not significantly differ between groups. However, at 36 months postoperatively, the vitreous cavity group required significantly more IOP-lowering medications (p = 0.044). The most common complication was encapsulation removal (39.5%), followed by tube obstruction (10.5%).
Conclusions:Surgical success rates and the duration of target IOP maintenance did not significantly differ between the anterior chamber and vitreous cavity groups. However, patients in the vitreous cavity group required more IOP-lowering medications postoperatively. These findings suggest that the tube insertion site should be considered when planning surgery for neovascular glaucoma.
