Titre du document / Document title

Comparison of double-plate Molteno and Ahmed glaucoma valve in patients with advanced uncontrolled glaucoma

Auteur(s) / Author(s)

AYYALA Ramesh S. ^{(1 2)} ; ZURAKOWSKI David ⁽³⁾ ; MONSHIZADEH R. ⁽⁴⁾ ; HONG Chian-Huey ⁽¹⁾ ; RICHARDS David ⁽⁵⁾ ; LAYDEN William E. ⁽⁶⁾ ; HUTCHINSON B. T. ⁽⁷⁾ ; BELLOWS A. R. ⁽⁷⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Ophthalmology, Tulane University Health Sciences Center, School of Medicine, New Orleans, Louisiana, ETATS-UNIS
⁽²⁾ Department of Ophthalmology, Medical Center of Louisiana, New Orleans, Louisiana, ETATS-UNIS
⁽³⁾ Department of Biostatistics, Children 's Hospital, Harvard Medical School, Boston, Massachusetts, ETATS-UNIS
⁽⁴⁾ University Eye Associates Inc, Boston University Medical Center, Boston, Massachusetts, ETATS-UNIS
⁽⁵⁾ Department of Ophthalmology, University of South Florida, Tampa, ETATS-UNIS
⁽⁶⁾ University Glaucoma Center, Tampa, Florida, ETATS-UNIS
⁽⁷⁾ Ophthalmic Consultants of Boston, Inc., Boston, Massachusetts, ETATS-UNIS

Résumé / Abstract

■ BACKGROUND AND OBJECTIVE: To compare double-plate Molteno (DPM) with the Ahmed glaucoma valve (AGV) in the treatment of eyes with complicated glaucoma. ■ PATIENTS AND METHODS: This matched, retrospective, case-control study was based on diagnosis, number of previous operations, and age. There were 30 patients in each group and only patients with a minimum of 6 months follow up were included. Double-plate Molteno or Ahmed glaucoma valve insertion was performed on each patient to control intractable glaucoma. Success was defined as IOP <22 mm Hg and >4 mm Hg on the last two visits, a decrease of no more than 2 lines in the visual acuity, and no additional surgical intervention to control IOP. ■ RESULTS: The Kaplan-Meier estimated probability of success at 12 and 24 months was 73% and 56% with DPM and 60% and 50% for AGV (P = 0.72). Mean IOP measured 13.36 ± 5.2 mm Hg following DPM and 16.7 ± 5.6 mm Hg following AGV at 12 months (P = 0.026) and 13.3 ± 5.1 mm Hg with DPM and 19 ± 5.8 mm Hg with AGV at 24 months (P = 0.009). Of the patients involved in the study, 83.5% exhibited hypertensive phase (HP) of AGV vs 43.5% of DPM (P = 0.04). AGV had a tendency to fail earlier (5 months ± 7 following AGV vs 13 months ± 13 following DPM, P = 0.07, t-test). Patients with either a second valve insertion or valve removal were 7/30 of AGV vs 1/30 in DPM (P = 0.05). Stent removal was needed by 10/30 DPM and 8/30 AGV had needling/5-FU. ■ CONCLUSIONS: The percentage of patients free from failure was similar between the two groups at 36 months. DPM is associated with lower mean IOP in the long term compared to AGV.

Revue / Journal Title

Ophthalmic surgery and lasers   ISSN 1082-3069   CODEN OSLAF2 

Source / Source

2002, vol. 33, n^o2, pp. 94-101 (12 ref.)

Langue / Language

Anglais

Editeur / Publisher

Slack, Thorofare, NJ, ETATS-UNIS  (1995-2000) (Revue)

Mots-clés anglais / English Keywords

Surgery ; Eye disease ; Patient ; Human ; Implant ; Technique ; Treatment ; Comparative study ; Valve ; Chemotherapy ; Aqueous humor ; Surgical drainage ; Antiglaucomatous agent ; Treatment resistance ; Glaucoma (eye) ;

Mots-clés français / French Keywords

Chirurgie ; Oeil pathologie ; Malade ; Homme ; Implant ; Technique ; Traitement ; Etude comparative ; Soupape ; Chimiothérapie ; Humeur aqueuse ; Drainage chirurgical ; Antiglaucomateux ; Résistance traitement ; Glaucome ;

Mots-clés espagnols / Spanish Keywords

Cirugía ; Ojo patología ; Enfermo ; Hombre ; Implante ; Técnica ; Tratamiento ; Estudio comparativo ; Válvula ; Quimioterapia ; Humor acuoso ; Drenaje quirúrgico ; Antiglaucomatoso ; Resistencia tratamiento ; Glaucoma (ojo) ;

Localisation / Location

INIST-CNRS, Cote INIST : 14946, 35400010795236.0010