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. 2010 May 6:4:411-6.
doi: 10.2147/opth.s10005.

Efficacy and safety of the pars plana clip in the Ahmed valve device inserted via the pars plana in patients with refractory glaucoma

Manuel Diaz-Llopis  1 , David Salom, Salvador García-Delpech, Patricia Udaondo, Jose Maria Millan, J Fernando Arevalo
Affiliations

Efficacy and safety of the pars plana clip in the Ahmed valve device inserted via the pars plana in patients with refractory glaucoma

Manuel Diaz-Llopis et al. Clin Ophthalmol. .

Abstract

Purpose: To evaluate the efficacy and safety of the pars plana clip (PPC) in the Ahmed valve tube inserted via the pars plana in patients with secondary refractory glaucomas.

Methods: Prospective and interventional case series that included 10 patients with secondary refractory glaucoma. The pars plana vitrectomy and the implant of the modified tube were performed during the same surgery. Control of intraocular pressure (IOP) and the development of intra- and postoperative complications were evaluated during the follow-up.

Results: Follow-up time was twelve months in all the patients. Control of IOP was achieved in 90% of patients, and 70% needed no antiglaucoma treatment. The complications that occurred were transient hypotony in three cases, choroidal detachment in two cases, and one case of intraocular hemorrhage. No case of tube extrusion or tube kink was observed.

Conclusions: Our data suggests that implantation of the Ahmed tube modified with the PPC via the pars plana is safe and effective in patients with secondary refractory glaucomas.

Keywords: Ahmed valve; pars plana clip; pars plana vitrectomy; refractory glaucoma.

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Figures

Figure 1
Figure 1
Once the vitrectomy had been performed the Ahmed’s FP7 valve (New World Medical, Ranch Cucamoga, CA, USA) was purged with saline serum and sutured 15 mm from the corneal limbus with 5.0 nylon in either of the two superior quadrants.
Figure 2
Figure 2
The pars plana clip is a silicone device with an entry orifice in the upper face and an exit orifice in the lower face which the silicone tube passes through.
Figure 3
Figure 3
Five or six mm of the drainage tube was introduced into the eye through one of the sclerectomies used for the vitrectomy at 3.5 mm from the corneal limbus, making sure it was visible through the dilated pupil. The PPC was then sutured to the sclera with 8.0 nylon.
Figure 4
Figure 4
A patch of bovine pericardium Tutopatch (Tutogen Medical) was sutured over the pars plana clip with 8.0 nylon, and everything was then covered with the conjunctiva.
See this image and copyright information in PMC

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