ABSTRACT
PURPOSE: To evaluate intraocular pressure (IOP) and visual acuity (VA) results after glaucoma drainage device (GDD) implantation combined with simultaneous pars plana vitrectomy (PPV). MATERIAL AND METHODS: Retrospective review of 8 eyes (7 patients). The diagnosis was neovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy in 4 eyes, in a which a double plate Molteno implant was placed, and glaucoma secondary (GS) to complicated cataract surgery in 3 eyes and penetrating trauma in one eye, in which a glaucoma Ahmed valve was implanted. RESULTS: Mean preoperative IOP was 35.77 mmHg (20-50) and 11.5 mmHg (2-20) postoperatively, and mean number hypotensive drugs was decreased from 2.33 (0-3) before surgery to 0.62 (0-3) after it. Preoperative VA in NVG was light perception or counting fingers, and it was lost in three eyes. In GS, VA before surgery was below 0.1 in all eyes, and three months after surgery mean VA was 0.42 (0.1-0.8). Mean follow-up was 10.12 months (5-27). The complications were tube obstruction in two cases, one of these presenting also a suprachoroidal hemorrage and ptisis bulbi, plate exposure in one case, and bullous keratopathy as a late complication in another eye. CONCLUSIONS: The VA and IOP were well controlled with this procedure in GS. In NVG, IOP was controlled, but visual results were poor due to complications and the underlying pathology.
Subject(s)
Glaucoma Drainage Implants , Glaucoma/surgery , Vitrectomy , Aged , Aged, 80 and over , Cataract Extraction , Choroid Hemorrhage/etiology , Corneal Diseases/etiology , Diabetic Retinopathy/complications , Equipment Failure , Eye Injuries, Penetrating/complications , Female , Glaucoma/etiology , Glaucoma, Neovascular/etiology , Glaucoma, Neovascular/surgery , Humans , Intraocular Pressure , Male , Middle Aged , Molteno Implants , Postoperative Complications/etiology , Postoperative Complications/surgery , Retrospective Studies , Treatment OutcomeABSTRACT
Objetivo: Evaluar los resultados en cuanto a control de presión intraocular (PIO) y agudezavisual (AV) tras cirugía de implante de drenaje para glaucoma (DDG) combinada con vitrectomíapars plana (VPP) simultánea.Material y métodos: Revisión retrospectiva de 8 ojos (7 pacientes). El diagnóstico era glaucomaneovascular (GNV) secundario a retinopatía diabética proliferativa en 4 ojos, en los quese colocó un implante de Molteno de doble plato, y glaucoma secundario (GS) a cirugía decatarata complicada en 3 ojos y a traumatismo penetrante en otro, en los que se usó unaválvula de Ahmed.Resultados: La PIO media pasó de 35,77 mmHg (20-50) preoperatoria a 11,5 mmHg (2-20)postoperatoria, y el número de fármacos hipotensores medio de 2,33 (0-3) preoperatorio a0,62 (0-3) postoperatorio. En los GNV, la AV preoperatoria era percepción de luz o contardedos, y se perdió en 3 ojos. En los GS era inferior a 0,1, aumentando hasta una AV mediade 0,42 (0,1-0,8) a los 3 meses. El seguimiento medio fue de 10,12 meses (5-27). Las complicacionesfueron obstrucción del tubo por fibrina en 2 casos, uno de los cuales (GNV) presentóuna hemorragia supracoroidea tras la desobstrucción y evolución a ptisis bulbi, extrusióndel reservorio en un caso, y descompensación corneal tardía en un caso.Conclusiones: En los GS los resultados han sido buenos, con mejoría de la AV y PIO controlada.En los GNV se consiguió controlar la PIO y evitar dolor, pero los resultados visualesfueron malos por la enfermedad de base(AU)
Purpose: To evaluate intraocular pressure (IOP) and visual acuity (VA) results after glaucomadrainage device (GDD) implantation combined with simultaneous pars plana vitrectomy(PPV).Material and methods: Retrospective review of 8 eyes (7 patients). The diagnosis wasneovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy in 4 eyes, in awhich a double plate Molteno implant was placed, and glaucoma secondary (GS) tocomplicated cataract surgery in 3 eyes and penetrating trauma in one eye, in which aglaucoma Ahmed valve was implanted.Results: Mean preoperative IOP was 35.77 mmHg (20-50) and 11.5 mmHg (2-20) postoperatively,and mean number hypotensive drugs was decreased from 2.33 (0-3) before surgery to 0.62(0-3) after it. Preoperative VA in NVG was light perception or counting fingers, and it waslost in three eyes. In GS, VA before surgery was below 0.1 in all eyes, and three months aftersurgery mean VA was 0.42 (0.1-0.8). Mean follow-up was 10.12 months (5-27). Thecomplications were tube obstruction in two cases, one of these presenting also asuprachoroidal hemorrage and ptisis bulbi, plate exposure in one case, and bullouskeratopathy as a late complication in another eye.Conclusions: The VA and IOP were well controlled with this procedure in GS. In NVG, IOP wascontrolled, but visual results were poor due to complications and the underlyingpathology(AU)
