ĐÁNH GIÁ KẾT QUẢ BAN ĐẦU PHẪU THUẬT ĐẶT VAN AHMED QUA ĐƯỜNG HẦM CỦNG MẠC KHÔNG SỬ DỤNG MẢNH GHÉP RỜI ĐIỀU TRỊ BỆNH GLÔCÔM

Abstract

Objectives: To evaluate the efficacy of a modified graft-free technique for Ahmed glaucoma valve (AGV) tube implantation using a long scleral tunnel in reducing the risk of tube exposure through the conjunctiva. Methods: This study is a descriptive case series of patients who underwent AGV implantation with the modified long scleral tunnel technique without patch grafts. All patients were followed for at least 6 months. Main outcome measures included intraocular pressure (IOP) control, tube exposure and postoperative complications. Results: A total of 20 eyes from 20 patients were analyzed. The mean age at the time of surgery was 60,9 ± 15,0 years (range: 34 – 84 years). Various glaucoma types were represented, including neovascular glaucoma (50%), pseudoexfoliation glaucoma, primary open-angle glaucoma, glaucoma post-vitrectomy, glaucoma corticoid and glaucoma post-trauma. The mean preoperative visual acuity was 1,29 ± 0,81 logMAR. Mean IOP decreased significantly from 32,44 ± 11,07 mmHg (range: 21,8 – 52 mmHg) preoperatively to 14,03 ± 7,28 mm Hg (range: 4,9 – 20,6 mmHg; p < 0,005) at the 6-month follow-up. No cases of tube exposure were observed during the follow-up period. Conclusions: The modified long scleral tunnel technique for AGV implantation without patch grafts was effective and safe, providing satisfactory IOL control and preventing tube exposure throughout the follow-up period. This technique eliminates the need for donor tissue and may be particularly advantageous in settings with limited access to patch graft materials.