Combined pars plana vitrectomy and Ahmed glaucoma drainage implant placement for neovascular glaucoma combined with vitreous hemorrhage

Objective To report visual acuity and intraocular pressure outcomes among patients who have undergone combined pars plana vitrectomy and placement of Ahmed glaucoma drainage implant.Methods The medical records of all patients who underwent combined pars plana vitrectomy and placement of Ahmed glaucoma drainage implant at the Shenyang the forth Eye Institute by one of the authors between January 1,2003,and February 28,2006,were reviewed.48 patients(52 eyes) were identified,including 36 patients with neovascular glaucoma secondary to proliferative diabetic retinopathy,8 central retinal vein occlusion,4 patients with other posterior segment disease(Eals' disease) Main outcome measures included visual acuity and intraocular pressure postoperatively.Results The follow-up ranged from 3 to 15 months.The cumulative probabilities of success at 6,12,15 months were(76.67± 5.26)%、(56.76±3.79)%、(52.56±3.21)% respectively.Intraocular pressure was reduced from a preoperative mean of(42.00±13.04)mmHg to a postoperative mean of(17.92±5.61)mmHg.The main complications include transient hypotony,tube blockage,hemorrhage,exposure of tube.Conclusion Although combined pars plana vitrectomy and placement of Ahmed glaucoma drainage implant is often a successful management option in selected patients with refractory glaucoma,visual outcome may be poor because of severe underlying ocular disease and postoperative complications.