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KMID : 1191420110100020115
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Korean Journal of Optometry and Vision Science
2011 Volume.10 No. 2 p.115 ~ p.120
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A Case of Non-surgical Treatment of Complications Occurring Simultaneously in Each Eye after Ahmed Valve Implantation
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Kim Jee-Wook
Ha Seung-Joo
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Abstract
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Purpose: To report the case of successful treatment of postoperative complication including hypotony using cycloplegic agent and the valve obstruction using membranectomy with Neodymium:YAG (Nd:YAG) laser after Ahmed valve implantation in a neovascular glaucoma (NVG) patient.
Methods: A 51-year-old female visited the hospital with ocular pain in both eyes. During her first visit, intraocular pressure (IOP) was 60 mmHg in the right eye and 50 mmHg in the left eye. In the anterior segment examination, neovascularizations of iris were noticed in both eyes. NVG was diagnosed and Ahmed valves were implanted in her both eyes. The next day after operation, obstruction of the end of the valve with massive fibrous membrane was observed in her right eye. IOP did not decreased sufficiently. Thus, we performed membranectomy using Nd:YAG laser at the end of the valve. Next day, IOP was normalized. Meanwhile in her left eye, three days after operation, hypotony was occurred with shallow anterior chamber. We used cycloplegic agent three times a day, and then the anterior chamber became deeper after two days. IOP was also normalized gradually.
Results: We have experienced postoperative complications including valve obstruction and hypotony with shallow anterior chamber simultaneously. And we treated successfully with nonsurgical methods. We observed that membranectomy using Nd:YAG laser is effective to treat the valve obstruction in a patient who is difficult to undergo additional surgery or antifibrotic agent. And cycloplegic agent that induce posterior shift of the lens-iris diaphragm could be the one of the options to treat hypotony with shallow anterior chamber.
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KEYWORD
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Ahmed valve implantation, Neovascular glaucoma, Postoperative complications
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