Refractory secondary glaucoma-clinical case

Rationale and objective:The major objective of treatment in glaucomatous disease is the decrease of intraocular pressure while maintaining the patient's vision and quality of life. Despite therapeutic possibilities, some cases of glaucoma remain refractory to treatment with the maintenance of elevated intraocular pressure and further progression of the disease. Artificial drainage systems, Ahmed valve, is a treatment alternative for refractory glaucoma when medical therapy, laser or conventional surgery have shown no results. Methods and results: We present the case of a patient presenting with refractive to medical treatment secondary glaucoma, following cataract surgery and vitrectomy for retinal detachment. Discussions: One of the complications of vitreoretinal surgery is secondary glaucoma. Some of the patients with this type of glaucoma are unresponsive to conventional medical therapy. In such situations, a DPS implantation is needed such as an Ahmed valve in our case. There are situations in which classical surgery-trabeculectomy - has no theoretical chance of success (in cases of neovascular glaucoma, secondary glaucoma, and inflammatory glaucoma post vitreoretinal surgery), [5,6]. Even though ASD are only used for refractory glaucoma, in this type of glaucoma, ADS can be used successfully as first line surgery. Abbreviations ADS = artificial drainage system; IOP = intraocular pressure; BCVA = best correct visual acuity; CA inhibitor = carbonic anhydrase inhibitor; OCT = optical coherence tomography