Value of Intravitreal Gas Injection With Ahmed Valve Implantation in the Prevention of Suprachoroidal Hemorrhage in Aphakic, Aniridic, and Vitrectomized Glaucomatous Eyes: A Pilot Study

• Published in: Journal of glaucoma Vol. 26; no. 6; p. e190
• Main Authors: El-Saied, Heba M A, Adullatif, Abdussalam M
• Format: Journal Article
• Language: English
• Published: United States 01.06.2017
• Subjects: Adult; Aniridia - complications; Aphakia - complications; Choroid Hemorrhage - prevention & control; Choroid Hemorrhage - surgery; Female; Fluorocarbons - administration & dosage; Glaucoma - surgery; Glaucoma Drainage Implants - adverse effects; Humans; Intraocular Pressure; Intravitreal Injections; Male; Middle Aged; Pilot Projects; Postoperative Hemorrhage - prevention & control; Tonometry, Ocular - adverse effects; Visual Acuity; Vitrectomy - adverse effects
• ISSN: 1536-481X
• DOI: 10.1097/IJG.0000000000000657

The aim of this study was to assess the value of intravitreal injection of nonexpansile C3F8 12% in the prevention of suprachoroidal hemorrhage (SCH) after Ahmed valve implantation for the treatment of secondary glaucoma in vitrectomized, aphakic, and aniridic eyes following blunt trauma. This is a case series of 5 patients who presented with traumatic secondary glaucoma in vitrectomized, aphakic, and aniridic eyes. Vitrectomy was performed in all eyes after trauma for the treatment of the vitreous hemorrhage. Ahmed valve implantation with complete filling of the vitreous cavity with nonexpansile C3F8 was carried out 2±0.2 months after vitrectomy. The outcome measures were evaluating the value of intraoperative filling of the vitreous cavity with gas in preventing SCH after Ahmed valve implantation and the ability of Ahmed valve implantation to control the intraocular pressure (IOP) in vitrectomized, aphakic, and aniridic eyes. All patients were examined up to 6 months. Inspite of the multiple risk factors present in our patients in the form of aphakia, vitrectomized eyes, and aniridia, no patient developed postoperative hypotony or SCH during the postoperative period. The gas was absorbed over 2 months and the IOP was maintained during the early postoperative period. Mean postoperative IOP was 15.2±1.09, 12.2±1.09, 18.4±7.12, 15.2±2.28, and 14.8±1. 09 mm Hg at 1 day, 1 week, 1 month, 3 months, and 6 months, respectively. The final postoperative best-corrected visual acuity was 0.66±0.13. Complete filling of the vitreous cavity with nonexpansile gas can prevent postoperative SCH after Ahmed valve implantation in the treatment of secondary glaucoma in vitrectomized, aphakic, and aniridic eyes.