Ahmed valve encapsulation as a main cause of its implantation failures

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Objective. To study the relationship of post-operative ocular hypertension with the encapsulation of Ahmed valve’s plate. Methods. The standard Ahmed valve implantation was performed in 238 patients aged 18-86 with multiple glaucoma surgeries (39 %), secondary neovascular (36 %), pseudophakic (23 %), juvenile (8 %), uveal (5 %) and post-traumatic (2 %) glaucomas. A routine ophthalmic examination was performed in 1 week, 1, 3, 6, 9, 12 and 36 months after surgery. Results. Excision of the fibrous capsule as the only way to cope with post Ahmed valve ocular hypertension was performed on 16 patients 3-36 months after surgery. Macro- and microscopic analysis of the excised capsules was done. In all cases, preparations of 1.2-2.2 mm thickness were obtained. We found a bilaminar structure of the capsule, the inner surface consisting of densely-packed collagen fibers, whereas the outer layer is represented by a loose fi-brovascular layer. Suspension of encapsulation is possible at initial stages of scarring, by applying ocular massage, needling, revision of the surgical area, and injection of antimetabolites.

作者简介

Vadim Nikolayenko

Ophthalmologic Center of City hospital N 2

Email: dr.Nikolaenko@mail.ru
MD, doctor of medical science, head of ophthalmology center

Larisa Konstantinova

Ophthalmologic Center of City hospital N 2

Email: Dr.KonstantinovaLM@mail.ru
head of ophthalmology department N 1

Olga Pavlova

Ophthalmologic Center of City hospital N 2

Email: olga-g-p@rambler.ru
ophthalmologist

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