| 신생혈관 녹내장에서 Diode 레이저 모양체 광응고술과 Ahmed 녹내장밸브 삽입술의 치료효과 비교 |
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김황기, 손용호 |
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Myung-Gok Eye Research Institute, Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea |
| The Comparison of the Therapeutic Effect between Diode Laser Cyclophotocoagulation and Ahmed Valve Implantation in the Management of Neovascular Glaucoma |
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Hwang-Ki Kim, Yong-Ho Sohn |
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| Abstract |
Purpose
To investigate the therapeutic effect and the usefulness of diode laser trans-scleral cyclophotocoagulation and Ahmed valve implantation in the management of neovascular glaucoma. Methods: The medical records of the patients with neovascular glaucoma who had been treated with diode laser cyclophotocoagulation (group 1, 25 eyes of 25 patients) or Ahmed valve implantation (group 2, 25 eyes of 23 patients) with follow-up period of at least 6 months were reviewed retrospectively. Results: The therapeutic effects of these two different surgical options were compared and analyzed in terms of IOP (intraocular pressure)-lowering effect, vision preservation, and complications. As for IOP-lowering effect, the success rate is higher in Ahmed valve implantation group with statistical significance than in Diode laser cyclophotocoagulation group, except postoperative 3 and 4 months (Pearsons chi-square test, p＜0.05). Twenty four eyes (96%) in group 1 (CPC) and eighteen eyes (72%) in group 2 (Shunt operation) kept their preoperative visual acuity after treatment. Improvements of visual acuity were noted in six eyes (24%) in group 2 and none of eyes in group 1. Reduced visual acuity were noted in one eye (4%) in each group respectively. Complications included iridocyclitis (76%), hyphema (36%), ocular pain (20%), corneal epithelial defect (4%), phthisis (4%) in group 1, and hyphema (48%), fibrinous iridocyclitis (44%), hypotony (29%), shallow anterior chamber (20%), ocular pain (8%), corneal epithelial defect (8%), blocked tube (4%) in group 2. All the complications were improved with the conservative treatment in both groups. Conclusions: Although intraocular pressure (IOP)-lowering effect was better and stable in group 2, neovascular glaucoma would be managed more effectively with establishing proper indications and complementing the demerits of each procedure. (Korean J Optom Vis Sci 2011;10(2):86-94) |
| Key Words:
Ahmed valve implantation, Intraocular pressure, Diode laser cyclophotocoagulation, Neovascular glaucoma |
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