Implantation of Ahmed drainage device in secondary “silicone” glaucoma. Features of the postoperative course

BACKGROUND: Despite the high technological effectiveness of treatment methods for vitreoretinal conditions, secondary glaucoma is a fairly common complication in the postoperative period, especially after tamponade with silicone oil. AIM: The aim of this study is to evaluate the effectiveness of Ahmed valve drainage device implantation in secondary glaucoma after vitreoretinal surgery with silicone oil tamponade and after the silicone oil removal. MATERIALS AND METHODS: The study included 42 patients with secondary glaucoma after vitreoretinal procedures with silicone oil tamponade for rhegmatogenous retinal detachment. Patients were divided into two groups: group 1 included 27 patients with avitria after silicone oil removal, group 2 — 15 patients with silicone oil tamponade in whom silicone oil removal was not indicated for various reasons. Before surgery, decompensation of intraocular pressure was detected in all patients (32.5 ± 2.9 mmHg, at the maximum hypotensive regimen), visual acuity varied from counting fingers to 0.5 with no correction of refractive error possible. RESULTS: In all cases, anti-glaucoma surgeries with Ahmed valve implantation were performed without complications. In the early postoperative period, the hypotensive effect was achieved in 100% of cases in both groups, the level of intraocular pressure on the first day after surgery in patients with avitria after removal of silicone oil averaged 9.3 ± 1.5 mmHg, in the group with silicone oil in the vitreal cavity — 10.2 ± 1.8 mmHg. The most common complication in the early postoperative period in patients with silicone oil tamponade was a shallow anterior chamber (in 40% of cases). Intraocular pressure was compensated in all patients within 12 months. CONCLUSIONS: The use of Ahmed drainage device is an effective method of intraocular pressure normalization in patients with secondary glaucoma after vitreoretinal procedures, both with silicone oil tamponade and avitria.