Abstract:AIM: To investigate the effect of Ahmed glaucoma drainage valve implantation on corneal endothelial cell density and intraocular pressure in patients with neovascular glaucoma.
METHODS: Totally 200 cases(200 eyes)of patients with neovascular glaucoma in our hospital from June 2013 to June 2016 were enrolled in this study. All patients were treated with glaucoma drainage valve implantation. The medical records of the patients were retrospectively analyzed; the evaluation of operation completion was made; intraocular pressure at preoperative and postoperative 1wk, 1mo, 1a was detected using non-contact tonometry; the corneal endothelial cell density at preoperative and postoperative 1wk, 1mo and 1a was tested by corneal endothelial microscopy, and visual acuity of patients before operation and at 1a after operation was recorded. All patients' complications and intervention methods were followed-up and recorded.
RESULTS: All patients' complete success rate was 81.0%, the conditional success rate was 92.0%. The proportion of preoperative and postoperative vision without light perception, hand moving to 0.01,0.02-0.05, 0.06-<0.10, ≥0.10 had significant difference(P>0.05). Intraocular pressure before treatment was 42.43±3.43mmHg, and were 13.45±2.34mmHg, 15.89±2.67mmHg, 16.34±2.88mmHg at 1wk, 1mo and 1a after operation respectively, showing significant difference(F=4570.62, P<0.001). Before treatment, corneal endothelial cell density was 2453.67±342.34/mm2, and were 2216.67±332.32/mm2, 2087.34±326.45/mm2, 1959.67±303.34/mm2 at 1wk, 1mo and 1a after operation respectively,holding significantly different(F=83.42, P<0.001). There were macular degeneration 20 eyes of hyphema, 13 eyes of low pressure, 8 eyes of drainage valve displacement and 21 eyes of shallow anterior chamber.
CONCLUSION: Ahmed glaucoma drainage valve implantation for neovascular glaucoma can effectively control intraocular pressure but the presence of corneal endothelial cell loss exists, can effectively protect and recover residual vision of patients, relief complications and recover it after simple intervention,it is an effective method for neovascular glaucoma.