Original Article

Clinical Results of Inferiorly Implanted Glaucoma Drainage Devices - Original Article

  • Nilgün Özkan Aksoy
  • Ilgaz Sagdiç Yalvaç
  • Banu Solmaz Satana
  • Ümit Eksioglu
  • Remzi Kasim
  • Bekir Sitki Aslan
  • Sunay Duman

Received Date: 04.06.2007 Accepted Date: 14.12.2007 Turk J Ophthalmol 2008;38(3):180-184

Purpose: To determine the success and complications of glaucoma drainage devices implanted other than classical superotemporal quadrant. Patients and Methods: A retrospective study was performed on 82 eyes of 82 patients that underwent tube implantation of superior and inferior quadrants. We performed Ahmed Glaucoma Valve insertion on 42 (68.9%) of 61 (74.4%) eyes and Molteno implantation on 19 (31.1%) eyes in classical superotemporal quadrant (Group 1). Glaucoma drainage devices other than classical superotemporal quadrant implantation was performed on 21 (25.6%) eyes (Group 2). In group 2; 15 (71.4%) of 21 eyes underwent Ahmed Glaucoma Valve insertion and 6 (28.6%) of 21 eyes underwent Molteno tube implantation. We compared intraocular pressure (IOP), visual acuity, surgical success, secondary surgery and complications between groups. Results: The median follow-up was 21 ± 17.5 (6-84) months. The mean IOP was 17.8±8.19 (4-38) mm Hg in Group 1 and 19.8±6.63 (7-28) mm Hg in Group 2 at the last follow-up (p: 0.297). There was no difference in postoperative visual acuities between the groups (p:0.659). The Kaplan-Meier survival analysis was 45.3% at first year, 37.3% at second year, 29.6% at third year in Group 1 and 64.8% at first year, 58.9% at second year, 51.5% at third year in Group 2. There was no significant difference in surgical success between the groups (p:0.800). Secondary operations were performed on 16 (37.5%) patient in Group 1 and 8 (37.5%) patients in Group 2 (p: 0.196). Endophthalmitis was seen on 1 (1.63%) patient in Group 1; and 2 (9.52%) patients in Group 2 (p: 0.800). Conclusion: Glaucoma drainage device implantation other than classical placement appears to be equally successful for control of IOP and shows same incidence for complications when compared with classical superotemporal placement.

Keywords: Glaucoma, Seton, Ahmed Glaucoma Valve, Molteno Implant

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