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Comparison of surgical outcomes of ExPRESS shunt and Ahmed valve in neovascular glaucoma

Poster Details

First Author: I.Elhawary SAUDI ARABIA

Co Author(s):    A. Ahmed                    

Abstract Details

Purpose:

Neovascular glaucoma is a potentially devastating form of secondary glaucoma, which have a guarded visual prognosis. In the advanced stages of neovascular glaucoma, surgical management is often required to manage elevated intraocular pressure.The use of Ex-Press shunt and glaucoma drainage implant are two procedures often considered in managing patients who are refractory to medical therapy. Post operative intraocular pressure outcomes , decrease in need for glaucoma drops and surgical complications with either procedure were studied.

Setting:

Magrabi Eye Hospital, Jeddah, Saudi Arabia

Methods:

A retrospective comparative case series of Ahmed Valve and Ex-Press Shunt performed by the same surgeon. Patients with less than 3 post operative visits or more than one glaucoma surgery have been excluded. Pre-operative visual acuity (VA), intra- and post-operative complications, pre and post surgical IOP and glacuoma medications have been recorded.

Results:

21 Neovascular glaucoma patients with Ahmed Valve vs. 6 Ex-Press shunt were included in the study.Mean patient age was 70 years. Mean F/U time was 14 months for Ahmed Valve and 9.4 months for Ex-Press Shunt. 2 out of 23 Ahmed Valve patients required repeat excisional surgery but no Ex-Press Shunt required repeat surgery. These patients have been excluded from study. 2 out of 21 Ahmed Valve patients had hyphema, 1 Ahmed Valve patient had choroidal effusion.Ex-Press shunt patients required less glaucoma drops than Ahmed Valve patients. Mean IOP decrease in Ahmed Valve vs. Express Shunt was statistically not different.

Conclusions:

Data suggests that Ex-Press shunt might be as or even more efficous in the treatment of neovascular glaucoma. Ex-Press shunt and Ahmed Valve lowered the IOP similarly. In addition, Ex-Press shunt patients required less glaucoma medications overall. Further research including recruitment of more patients and data points is required to confirm the role of express shunt in neovascular glaucoma.

Financial Disclosure:

NONE

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