망막질환이 동반된 난치성 녹내장에서의 유리체절제술과 평면부를 통한 아메드장치삽입술

Pars Plana Vitrectomy and Ahmed Valve Implantation for Intractable Glaucoma Comorbid With Retinal Disorders

Purpose: To evaluate the efficacy and long-term prognosis of pars plana vitrectomy and Ahmed valve implantation for intractable glaucoma comorbid with retinal disorders. Methods: A retrospective review of 34 eyes of 30 patients receiving pars plana vitrectomy and Ahmed valve implantation for intractable glaucoma comorbid with retinal disorders was performed. Preoperative and postoperative intraocular pressure (IOP) and visual acuity, the usage of IOP-lowering medications and postoperative complications, and surgical success rate were evaluated. Results: IOP and the number of IOP-lowering medications showed a significant decrease after pars plana vitrectomy and Ahmed valve implantation, as compared to before surgery (p < 0.001). The success rate was 88%, 88%, 84% and 85% postoperatively at 1 month, 6 months, 1 year and 3 years respectively. The mean follow up period was 24.21 ± 14.99 months. Complications related to surgery included hyphema in 2 eyes, recurrent corneal epithelial erosion and defect in 2 eyes, corneal ulcer in 2 eyes and vitreous hemorrhage in 4 eyes. Visual acuity improved in 14 eyes (41.1%), no changes in 13 eyes (38.2%) and decreased in 7 eyes (20.6%). Conclusions: Pars plana vitrectomy and Ahmed valve implantation for intractable glaucoma comorbid with retinal disorders show long-term efficacy in lowering IOP. J Korean Ophthalmol Soc 2011;52(1):46-52