Malignant glaucoma after XEN45 implant. / Glaucoma maligno tras implante XEN45.

Minimally invasive glaucoma surgery for chronic open-angle glaucoma treatment tries to reduce the amount of chronic topical drug treatment, delaying invasive glaucoma surgery and diminishing the number of surgical complications. XEN45 uses subconjunctival drainage in order to reduce intraocular pressure. The report is presented of a patient following phacoemulsification, intraocular lens implantation and XEN45 implant. After four days acute malignant glaucoma was observed, with stage 3 athalamia requiring pars plana vitrectomy and secondary Ahmed valve implantation. The lower rate of complications due to minimally invasive glaucoma surgery has increased its use. Nevertheless, it is not free of severe adverse events, even requiring a multidisciplinary approach as in our malignant glaucoma report.

Ahmed valve for elevated intraocular pressure associated with black diaphragm lenses for aniridia.

PURPOSE: To evaluate the Ahmed valve for decrease elevated pressure associated with black diaphragm lenses for aniridia. METHODS: Drainage devices are useful to obtain good control of intraocular pressure in patients with aniridia and the authors often use them because of the poor results of medical therapy or filtering surgery. However, when the elevated intraocular pressure is associated with black diaphragm lenses for aniridia, most authors decide to carry out a filtering technique. The current authors opted for the implantation of an Ahmed valve in three patients, two with traumatic aniridia and the other with a congenital case. Every patient had a different kind of black diaphragm lens for aniridia. RESULTS: The Ahmed valve controlled the intraocular pressure in levels below 20 mmHg for a follow-up year with no complications derived from its application. CONCLUSIONS: Ahmed valve implantation was the best technique to decrease intraocular pressure in patients with aniridia. The authors have used it successfully for cases with elevated pressure associated with black diaphragm lenses for aniridia.

[Contrast sensitivity to intraocular lens TECNIS Z-9000]. / Sensibilidad al contraste en las lentes TECNIS Z-9000.

PURPOSE: To evaluate the increase in contrast sensitivity to intraocular lens TECNIS Z-9000 (Pfizer) compared with other intraocular lenses. METHOD: We implanted a TECNIS Z-9000 lens in 18 patients who had another type of intraocular lens implanted in their other eye. We then tested contrast sensitivity under both mesopic and photopic conditions using the VCTS (Vision Contrast Test System) provided by Vistech Consultants Inc. RESULTS: There was an improved contrast sensitivity at low and medium frequencies, following TECNIS-Z 9000 lens implantation, however this improvement did not reach statistical significance. There were significant differences at high frequencies, which are directly related to the quality of visual function. CONCLUSIONS: TECNIS Z-9000 lens implantation (with a modified anterior surface) achieves a significant improvement in contrast sensitivity, meaning in practice an increase in the quality of visual function.