| 본문 : Introduction: A 41–year-old man with advanced open-angle glaucoma on right eyes was referred to glaucoma clinic in CHA Bundang Medical Center because of uncontrolled intraocular pressure (IOP) despite the medical treatment. His left eye was diagnosed as ocular hypertension (without visual field defect). He had a cataract surgery on his right due to traumatic cataract 20 years ago and the best corrected visual acuity of his right eye was 0.8. The preoperative IOPs were 23 mmHg (right eye) and 16 mmHg (left eye) on topical preservative-free timolol plus dorzolamide fixed combination, brimonidine, and bimatoprost eyedrops application.
Methods: A biodegradable collagen matrix augmented Ahmed valve implantation (BAAVI) method, which was described else where, was performed on his right eye. As a brief description, after making scleral flaps, a biodegradable collagen polymer implant of 2 mm x 10 mm x 10 mm size (Ologen implant, Aeon Astron Corporation, Taipei, Taiwan) was placed over the plate part of an Ahmed glaucoma valve (AGV, New World Medical Inc, Rancho Cucamonga, CA, USA) and AGV was implanted in the subtenon’s space. In addition to conventional Humphrey visual field test (24-2 Sita-standard, Humphrey Field Analyzer II, Dublin, CA), Macular Integrity Assessment (MAIA; CenterVue, Padova, Italy) was performed to detect the change of his visual field sensitivity.
Results: The IOP decreased to around 15 mmHg after the surgery and has remained stable for 3 months follow up without any anti-glaucoma medication or additional procedures like bleb needling or antimetabolite use. The mean deviation (MD) and the visual field index of right eye were -33.11 dB and 0%, respectively. Macular Integrity Assessment (MAIA; CenterVue, Padova, Italy) showed increased macular sensitivity in 14 / 37 measurement points (center 10 degrees) after 3 months. There was no clinically significant complication during the follow-up.
Conclusions: This is the first report to describe the outcome of the BAAVI method in an end-stage glaucoma case showing positive potential. |