Surgical results of Ahmed valve implantation combined with intravitreal triamcinolone acetonide injection for preventing choroidal detachment

BACKGROUND: To investigate the surgical results of Ahmed valve implantation with intravitreal triamcinolone acetonide injection (IVTA) in patients with aphakic or pseudophakic glaucoma. METHODS: Fifty-nine patients who underwent Ahmed valve implantation were consecutively recruited from November 2005 to August 2011 at the Beijing Tongren Hospital. In the IVTA group (29 eyes), 4 mg of TA was injected into the vitreous cavity during Ahmed valve implantation was performed. In the control group (30 eyes), only Ahmed valve implantation was performed. The primary outcome was intraocular pressure (IOP). The visual acuity (VA), supplemental medical therapy and complications were evaluated as secondary outcomes. RESULTS: The IVTA and control groups were followed up for a mean of 22.7 and 31.4 months, respectively. IOP decreased in both groups at 1 day, 1 week, 1 month and the final follow-up points after the surgery. However, there was no significant difference between 2 groups at all intervals (P > 0.05). The rate of shallow anterior chamber and choroidal detachment in IVTA group was significantly lower than control group (6.9% vs. 40%, P = 0.007; 0% vs. 26.7%, P = 0.009). CONCLUSIONS: Ahmed valve implantation combined IVTA seems to be effective to reduce the incidence of complications for treatment of aphakic or pseudophakic glaucoma.