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KMID : 1191420110100020086
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Korean Journal of Optometry and Vision Science
2011 Volume.10 No. 2 p.86 ~ p.94
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The Comparison of the Therapeutic Effect between Diode Laser Cyclophotocoagulation and Ahmed Valve Implantation in the Management of Neovascular Glaucoma
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Kim Hwang-Ki
Sohn Yong-Ho
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Abstract
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Purpose: To investigate the therapeutic effect and the usefulness of diode laser trans-scleral cyclophotocoagulation and Ahmed valve implantation in the management of neovascular glaucoma.
Methods: The medical records of the patients with neovascular glaucoma who had been treated with diode laser cyclophotocoagulation (group 1, 25 eyes of 25 patients) or Ahmed valve implantation (group 2, 25 eyes of 23 patients) with follow-up period of at least 6 months were reviewed retrospectively.
Results: The therapeutic effects of these two different surgical options were compared and analyzed in terms of IOP (intraocular pressure)-lowering effect, vision preservation, and complications. As for IOP-lowering effect, the success rate is higher in Ahmed valve implantation group with statistical significance than in Diode laser cyclophotocoagulation group, except postoperative 3 and 4 months (Pearsons chi-square test, p＜0.05). Twenty four eyes (96%) in group 1 (CPC) and eighteen eyes (72%) in group 2 (Shunt operation) kept their preoperative visual acuity after treatment. Improvements of visual acuity were noted in six eyes (24%) in group 2 and none of eyes in group 1. Reduced visual acuity were noted in one eye (4%) in each group respectively. Complications included iridocyclitis (76%), hyphema (36%), ocular pain (20%), corneal epithelial defect (4%), phthisis (4%) in group 1, and hyphema (48%), fibrinous iridocyclitis (44%), hypotony (29%), shallow anterior chamber (20%), ocular pain (8%), corneal epithelial defect (8%), blocked tube (4%) in group 2. All the complications were improved with the conservative treatment in both groups.
Conclusions: Although intraocular pressure (IOP)-lowering effect was better and stable in group 2, neovascular glaucoma would be managed more effectively with establishing proper indications and complementing the demerits of each procedure.
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KEYWORD
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Ahmed valve implantation, Intraocular pressure, Diode laser cyclophotocoagulation, Neovascular glaucoma
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