Ahmed valve encapsulation as a main cause of its implantation failures

Vadim Petrovich Nikolayenko; Larisa Mikhaylovna Konstantinova; Olga Gennadyevna Pavlova

doi:10.17816/OV2014218-22

Ophthalmology Reports ›› 2014, Vol. 7 ›› Issue (2) : 18 -22. DOI: 10.17816/OV2014218-22

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Ahmed valve encapsulation as a main cause of its implantation failures

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Abstract

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.

Keywords

refractory glaucoma / encapsulated filtering bleb / Ahmed drainage system

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Vadim Petrovich Nikolayenko, Larisa Mikhaylovna Konstantinova, Olga Gennadyevna Pavlova. Ahmed valve encapsulation as a main cause of its implantation failures. Ophthalmology Reports, 2014, 7(2): 18-22 DOI:10.17816/OV2014218-22

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