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Abstract
Purpose
To report the results of performing an Ahmed glaucoma valve implantation without removing the anterior chamber lens to treat secondary glaucoma.
Case summary
A 72-year-old male visited the hospital for imminent visual field loss in the left eye. At the time of the visit, he had a mild headache, and the intraocular pressure of the left eye was 38 mm Hg. The left eye had received anterior chamber lens insertion with iridectomy and the posterior capsule was ruptured. The vitreous protruded at the two o'clock site and adhered to the backside of the anterior chamber lens tilting it toward the temporal cornea. At the time of the visit, the maximum corrected vision of the left eye was 0.32. The patient was diagnosed with secondary glaucoma caused by the anterior chamber lens. Because the patient did not want to have the anterior chamber lens removed and the supporting area of the anterior chamber lens blocked the trabeculectomy and peripheral iridectomy sites, the authors performed an Ahmed glaucoma valve implantation instead. The outcome of Ahmed glaucoma valve implantation was evaluated through a preoperative and postoperative vision test and periodical corneal endothelial cell analysis. During the six months of post-operative follow-up, the vision was improved, intraocular pressure was stabilized, and corneal endothelial cells were maintained.
Conclusions
When a patient requires glaucoma surgery for secondary glaucoma caused by an anterior chamber lens, an Ahmed implantation without lens removal may be an option which may carefully be considered. However, because of the possibility of subsequent complications, a longer follow-up period is necessary.
References
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Figure 2.
The left eye on the visit. The left eye had received anterior chamber lens insertion and iridectomy and the posterior capsule had already ruptured. In addition, the vitreous body escaped in the direction of two o'clock and stuck on the backside of the anterior chamber lens, and the anterior chamber lens was tilted toward the temporal cornea.
Figure 3.
In the preoperative corneal endothelial cell analysis of the left eye, the corneal endothelial cell density was 579 cells/mm2.
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