The purpose of the study was to compare the efficacy of Ex-Press and Ahmed drainage devices for the secondary neo-vascular glaucoma (NVG) in patients with diabetes mellitus. We observed 25patients (25eyes) with secondary NVG in the setting of proliferative diabetic retinopathy. The first group consisted of 10patients (10eyes) who underwent Ex-Press drainage implantation. The second group consisted of 15patients (15eyes) who were implanted Ahmed valve FP7 model. As a result the maximum value of IOP in the analyzed groups decreased by 66.8% and 64.2% respectively immediately after the surgery. By the end of 18months follow-up period, the absolute hypotensive effect in patients of group1 was 20% (2/10) whereas in group2 – 60% (9/15). Normal intraocular tension during treatment with glaucoma medications established in 30% of cases in group1 (3/10) and in 80% of patients in group2 (12/15). Thus, the use of Ex-Press drainage device for secondary NVG in patients with diabetes was ineffective in 70% of cases. We can recommend choosing implantation of Ahmed valve for secondary NVG in patients with diabetes mellitus as the number of unsuccessful outcomes using Ahmed valve was observed only in 20% of cases.
Ex-Press, Ahmed glaucoma valve
1. BikbovMM, BabushkinAE, ChaikaOV, OrenburkinaOI,KhusnitdinovII (2015). Effectiveness of the drainage surgery in refractory glaucoma [Ob effektivnosti drenazhnoy khirurgii pri refrakternoy glaukome]. Oftal’mologiya. Vostochnaya Evropa, (3), 81-86.
2. BikbovMM, SurkovaVK, KhusnitdinovII, ChaikaOV, OrenburkinaOI, DzhamantaevaSD (2013). Results of implantation of Ahmed drainage system in patients with refractory glaucoma [Rezul’taty primeneniya drenazha Ahmed pri refrakternoy glaukome]. Klinicheskaya oftal’mologiya, (3), 98-101.
3. BikbovMM, KhusnitdinovII (2016). Results of combined surgery in patients with primary open angle glaucoma and complicated cataract with Glauteks drainage [Rezul’taty kombinirovannogo khirurgicheskogo vmeshatel’stva u bol’nykh s pervichnoy otkrytougol’noy glaukomoy i oslozhn`nnoy kataraktoy s ispol’zovaniem drenazha «Glauteks»]. Kataraktal’naya i refraktsionnaya khirurgiya, (1), 42-46.
4. GavrilovIA, ChuprovAD (2011). First experience of Ex-Press shunt surgery in refractory glaucoma [Pervyy opyt primeneniya shunta Ex-Press v khirurgii refrakternoy glaukomy]. Glaukoma: teorii, tendentsii, tekhnologii: Sbornik nauchnykh trudov 9-y konferentsii, 79-82.
5. EgorovEA (ed.) (2013). Glaucoma. National guidance [Glaukoma. Natsional’noe rukovodstvo], 824.
6. KryachkoNS, PureskinNP, MigalSF, MigalDS (2015). Results of the application of the Ex-Press shunt and the Glauteks drainage in treatment of secondary glaucoma [Rezul’taty primeneniya shunta Ex-Press i drenazha «Glauteks» v kompleksnom lechenii vtorichnoy glaukomy]. Novosti glaukomy, (1), 129-131
7. LipatovDV, ChistyakovTA (2008). Using the Ahmed valve for secondary neovascular glaucoma. [Ispol’zovanie klapana Akhmeda pri vtorichnoy rubeoznoy glaukome]. Glaukoma: real’nost’ i perspektivy: Sbornik nauchnykh statey, 52-56
8. PavlovaOG, NikolaenkoVP, KonstantinovLM (2014). Encapsulation of Ahmed valve as the main reason for implantation failure [Inkapsulyatsiya klapana Ahmed kak osnovnaya prichina neudach ego implantatsii]. Oftal’mologicheskie vedomosti, (2), 18-22.
9. ProkofievаMI (2010). Modern surgical approaches to the treatment of refractory glaucoma (review) [Sovremennye khirurgicheskie podkhody k lecheniyu refrakternoy glaukomy (obzor literatury)]. Klinicheskaya oftal’mologiya, (3), 104-108
10. BikbovMM, KhusnitdinovII (2015). The results of the use of Ahmed valve in refractory glaucoma surgery. J. Curr. Glaucoma Practice, 9(3), 86-91.
11. ColemanAL, HillR, WilsonMR, ChoplinN, Kotas-NaumannR, TamM, BacharachJ, PanekWC (1995). Initial clinical experience with the Ahmed glaucoma valve implant. Am. J. Ophthalmol., (120), 23-31.
12. De FeoF, RoccatagliataL, BonzanoL, CastellettiL,MancardiG, TraversoCE (2009). Magnetic resonance imaging in patients implanted with Ex-Press stainless steel glaucoma drainage microdevice. Am. J. Ophthalmol., 147(5), 907-911
13. Gallego-PinazoR, López-SánchezE, Marín-MontielJ (2009). Postoperative outcomes after combined glaucoma surgery. Comparison of Ex-Press miniature implant with standard trabeculectomy. Arch. Soc. Esp. Oftalmol., 84(6), 293-297
14. MincklerD, FrancisB, HodappE, JampelH, LinS, SamplesJ, SmithSD, SinghK (2008). Aqueous shunts in glaucoma. A report by the American Academy of Ophthalmology. Ophthalmology, (115), 1089-1098.
15. WamsleyS, MosterMR, RaiS, AlvimHS, FontanarosaJ (2004). Results of the use of the Ex-Press miniature glaucoma implant intechnically challenging advanced glaucoma cases: a clinical pilot study. Am. J. Ophthalmol., 138(6), 1049-1051
