Open AccessAhmed valve encapsulation as a main cause of its implantation failures
Author(s) -
Vadim Petrovich Nikolayenko,
L M Konstantinova,
Ol'ga Gennad'yevna Pavlova
Publication year - 2014
Publication title -
oftalʹmologičeskie vedomosti
Language(s) - English
Resource type - Journals
eISSN - 2412-5423
pISSN - 1998-7102
DOI - 10.17816/ov2014218-22
Subject(s) - medicine , capsule , surgery , glaucoma valve , ophthalmology , glaucoma , botany , biology
Objective. To study the relationship of post-operative ocular hypertension with the encapsulation of Ahmed valve’s plate. Methods. The standard Ahmed valve implantation was performed in 238 patients aged 18-86 with multiple glaucoma surgeries (39 %), secondary neovascular (36 %), pseudophakic (23 %), juvenile (8 %), uveal (5 %) and post-traumatic (2 %) glaucomas. A routine ophthalmic examination was performed in 1 week, 1, 3, 6, 9, 12 and 36 months after surgery. Results. Excision of the fibrous capsule as the only way to cope with post Ahmed valve ocular hypertension was performed on 16 patients 3-36 months after surgery. Macro- and microscopic analysis of the excised capsules was done. In all cases, preparations of 1.2-2.2 mm thickness were obtained. We found a bilaminar structure of the capsule, the inner surface consisting of densely-packed collagen fibers, whereas the outer layer is represented by a loose fi-brovascular layer. Suspension of encapsulation is possible at initial stages of scarring, by applying ocular massage, needling, revision of the surgical area, and injection of antimetabolites.