DIFFERENT SURGICAL MODALITIES FOR MANAGEMENT OF PERSISTENT GLAUCOMA AFTER SILICONE OIL REMOVAL IN VITRECTOMIZED EYES: One Year Comparative Study

• Published in: Retina (Philadelphia, Pa.) Vol. 37; no. 8; p. 1535
• Main Authors: El-Saied, Heba Magdy, Abdelhakim, Mohamad Amr Salah Eddin
• Format: Journal Article
• Language: English
• Published: United States 01.08.2017
• Subjects: Adolescent; Adult; Endotamponade - adverse effects; Female; Follow-Up Studies; Glaucoma - etiology; Glaucoma - physiopathology; Glaucoma - surgery; Humans; Intraocular Pressure - physiology; Male; Middle Aged; Prognosis; Prospective Studies; Reoperation; Sclerostomy - methods; Silicone Oils - adverse effects; Trabeculectomy - methods; Visual Acuity; Vitrectomy - adverse effects; Young Adult
• DOI: 10.1097/IAE.0000000000001393

Aim of this study was to compare outcome of four different surgical modalities for management of persistent glaucoma after silicone oil removal in vitrectomized eyes. This is a prospective comparative study, carried out on a cohort of 41 eyes (41 patients). Patients were randomly allocated to Group A (trabeculectomy), Group B (deep sclerectomy), Group C (Ahmed valve), or Group D (Ex-Press Minishunt). Postoperatively, all patients were followed regularly at 1 day, 1 week, 1, 3, and 6 months, and 1 year for intraocular pressure evaluation. Postoperatively, there was significant drop in intraocular pressure in each group, and significant difference between the four groups regarding drop and percentage drop in intraocular pressure, with Group C showing the highest mean percentage drop in intraocular pressure, whereas Group B with the least. Success rate was 100% with Ex-Press minishunt, 80% with Ahmed valve, and 50% for each of trabeculectomy and deep sclerectomy. Hypotony occurred in 50% with Ahmed valve and 40% with trabeculectomy, whereas glaucoma occurred in 50% with deep sclerectomy and 30% with trabeculectomy. For controlling persistent glaucoma after silicone oil removal in our work, Ex-Press minishunt had the highest complete success rate with no postoperative complications.