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학술저널
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대한안과학회 Korean Journal of Ophthalmology Korean Journal of Ophthalmology 제33권 제3호
발행연도
2019.1
수록면
214 - 221 (8page)

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Purpose: To investigate the clinical features and surgical outcomes of encapsulated bleb excision with collagenmatrix implantation performed in patients with failed Ahmed glaucoma valve (AGV) implantation. Methods: Eighteen eyes of 18 patients underwent encapsulated bleb excision and collagen matrix implantation. Patients were divided into two groups by reference to intraocular pressure (IOP) after preoperativeocular massage: group 1, patients who exhibited substantial IOP reductions; and group 2, patients who didnot show substantial changes in IOP. Needling was conducted in group 2. The clinical features of the twogroups were compared, including IOP changes after ocular massage and needling, AGV status, and surgicaloutcomes 6 months after surgery. Results: The mean preoperative IOP among the 18 patients was 30.6 ± 5.7 mmHg. After ocular massage, theIOPs decreased by 22 and 26 mmHg in the two patients in group 1 and the 16 patients in group 2 showed amean IOP reduction of 1.6 ± 2.2 mmHg (p = 0.013). IOPs decreased after needling in group 2 (range, 6 to 30mmHg; p < 0.001). Fibrovascular tissue ingrowth into the AGV was observed in the two patients in group 1and the same ingrowth was observed in 10 of the 16 patients in group 2. Six months after surgery the meanIOP among the 18 patients decreased significantly (19.1 ± 3.2 mmHg, p < 0.001). There was no significant differencein the mean postoperative IOP at 6 months between group 1 (14.0 ± 2.8 mmHg) and group 2 (19.8 ± 2.6mmHg, p = 0.052). Conclusions: Encapsulated bleb excision with collagen matrix implantation resulted in a significant IOP-loweringeffect 6 months after surgery. Fibrovascular ingrowth into the AGV was common but did not seem to bea major cause of AGV implantation failure.

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