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Published on: February 26, 2013
Comparison of choroidal detachment with and without hypotony after Ahmed valve implantation
Sang Wook Jin1, Jung Woo Heo2, Hee Bae Ahn2
1Department of Ophthalmology, Dong-A University College of Medicine, 32 Daesingongwon-ro, Seo-gu, Busan, 49201, Republic of Korea. swjin@dau.ac.kr.
Insights
Older age, diabetes, and hypertension increase the risk of choroidal detachment after Ahmed valve implantation. Neovascular glaucoma is a key factor, even without hypotony, requiring clinical attention post-surgery.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Ocular Complications
Background:
- Ahmed valve implantation (AVI) is a surgical procedure for glaucoma management.
- Choroidal detachment (CD) is a potential complication following glaucoma surgery.
- Understanding risk factors for CD after AVI is crucial for patient care.
Purpose of the Study:
- To compare clinical manifestations of choroidal detachment (CD) after Ahmed valve implantation (AVI).
- To identify risk factors associated with CD development, with or without hypotony, post-AVI.
Main Methods:
- Retrospective analysis of consecutive glaucoma patient cases undergoing AVI.
- Comparison of patients with and without CD, and further subgrouping of CD patients based on hypotony.
- Multivariate regression analysis to identify predictors of CD and analyze the relationship between hypotony and CD.
Main Results:
- Older age, pseudophakic status, diabetes mellitus (DM), and hypertension (HTN) were significant predictors of CD post-AVI.
- Neovascular glaucoma (NVG) cases showed a higher incidence of CD without hypotony compared to primary open-angle glaucoma (POAG) and exfoliative glaucoma (XFG).
- Anterior chamber formation treatment was more frequent in CD with hypotony than in CD without hypotony.
Conclusions:
- Older age, pseudophakic eyes, DM, and HTN are significantly associated with CD after AVI.
- NVG presents a higher risk for CD without hypotony post-AVI.
- Clinicians must monitor for CD after AVI, particularly in NVG patients, irrespective of hypotony status.
Purpose:
To compare the clinical manifestations of and risk factors for choroidal detachment (CD) with or without hypotony after Ahmed valve implantation (AVI).
Study Design:
Retrospective, consecutive case series.
Methods:
We enrolled patients with glaucoma who underwent AVI, and divided them into CD and non-CD groups. The patients with CD were divided into those with and without hypotony. Data collected from the chart review before and after AVI included patient demographics and ocular characteristics. We analyzed the risk factors for CD development. The relationship between hypotony and CD development was also analyzed.
Results:
Among the 387 eyes, 63 developed CD. Among these 63 eyes, 42 had CD with hypotony and 21 had CD without hypotony. Multivariate regression analysis revealed that age (P < 0.001), lens status (P < 0.001), history of diabetes mellitus (DM) (P = 0.011), and history of hypertension (HTN) (P = 0.002) were significant predictors of CD development. Neovascular glaucoma (NVG) showed 42.9% of CD cases without hypotony. This rate was higher than primary open angle glaucoma (POAG) and exfoliative glaucoma (XFG). The rate of anterior chamber formation as treatment of CD was significantly higher in CD with hypotony than in CD without hypotony.
Conclusions:
Older age, pseudophakic eyes, DM, and HTN are significantly associated with CD development after AVI. NVG has higher incidence rates of CD without hypotony compared with POAG and XFG. Therefore, clinicians should pay attention to CD development after AVI especially in NVG, even if a patient is not in a hypotonic state.
