[The efficacy of surgical treatment for encapsulated cystic blebs around the plate after Ahmed glaucoma valve implantation].

OBJECTIVE

To evaluate the efficacy of surgical treatment for encapsulated cystic blebs around the plate after Ahmed glaucoma valve implantation.

METHODS

This was a retrospective observational case series. Thirteen cases with elevated intraocular pressure (IOP) induced by fibrous proliferation around Ahmed valve were retrospectively studied. The intraocular pressure increased at 3 weeks to 5 months post-operation (2 months in average). The plates and tubes of Ahmed valve were in good position. No obstruction was seen in the tubes. Localized, encapsulated, cystic blebs were found in the equator of eyeball in which the plates were located. All cases underwent encapsulated cysts resection combined with mitomycin-C usage under conjunctival flaps. The excised tissues were sent for pathological examination. The changes of IOP and the outcome of the diseases were observed.

RESULTS

IOP was normal one month after surgery in all cases. The success rate was 100%. In the 3 - 20 months follow-up period, the IOP level kept normal in 3 cases without any anti-glaucoma medications. The IOP level was in normal range in 6 cases using two or three different kinds of anti-glaucoma medications. Three cases needed further surgical treatment because of uncontrolled IOP even with anti-glaucoma medications. Among them, the complete success rate was 75% (3/4) in patients more than 57 years old, while the complete success rate was 0 (0/8) in patients less than 37 years old.

CONCLUSIONS

It was considered an effective method of surgical treatment for encapsulated blebs around Ahmed glaucoma valve. The result was better in elderly patients than in younger patients relatively.