Comparison of Surgical Outcomes between Trabeculectomy and Aqueous Shunt Surgery in Patients with Iridocorneal Endothelial Syndrome

Jung Lim Kim; Jae Wook Yang

doi:10.3341/jkos.2012.53.5.668

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Kim and Yang: Comparison of Surgical Outcomes between Trabeculectomy and Aqueous Shunt Surgery in Patients with Iridocorneal Endothelial Syndrome

Original Article

Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(5): 668-673.

Published online: 16 May 2012

DOI: https://doi.org/10.3341/jkos.2012.53.5.668

Comparison of Surgical Outcomes between Trabeculectomy and Aqueous Shunt Surgery in Patients with Iridocorneal Endothelial Syndrome

Jung Lim Kim, MD, Jae Wook Yang, MD, PhD

Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address reprint requests to Jae Wook Yang, MD, PhD. Department of Ophthalmology, Inje University Busan Paik Hospital, #75 Bokji-ro, Busanjin-gu, Busan 614-735, Korea. Tel: 82-51-890-6016, Fax: 82-51-890-6329, eyeyang@inje.ac.kr

Received 15 April 2011 Accepted 7 April 2012

Abstract

Purpose

To compare surgical outcomes and corneal endothelial cell densities in patients with glaucoma secondary to iridocorneal endothelial (ICE) syndrome who underwent trabeculectomy with mitomycin-C (MMC) versus those who underwent Ahmed Glaucoma Valve (AGV) implantation.

Methods

Twenty-one patients with ICE syndrome who underwent either trabeculectomy with MMC or AGV implantation were included in this study. All patients had more than 12 months of follow-up after glaucoma surgery. Intraocular pressure (IOP), visual acuity (VA) and corneal endothelial cell density were compared according to the method of surgery.

Results

Ten eyes had undergone a trabeculectomy with MMC, and 11 eyes had an AGV implantation. In eyes that underwent a trabeculectomy with a MMC, there were no statistically significant differences between preoperative and postoperative month 12 in IOP, VA or corneal endothelial cell density. In eyes that underwent AGV implantation, postoperative IOP, VA and corneal endothelial cell density were statistically significantly lower than the preoperative values.

Conclusions

When determining the method of glaucoma surgery in patients with ICE syndrome, the additional procedures needed to maintain the surgical success of trabeculectomy with MMC and the corneal decompensation which is caused by a decrease in corneal endothelial cell density after AGV implantation should be considered.

Keywords: Ahmed valve implantation, Corneal endothelial cell density, Iridocorneal endothelial syndrome, Trabeculectomy

Figures and Tables

Figure 1

The changes in mean intraocular pressure (IOP) during the follow-up period. ^*Significantly higher intraocular pressure between the 2 groups (p < 0.05, independent t-test).

Figure 2

The changes in visual acuity in the groups during the follow-up period. There is no significant difference between the two groups at all the time points.

Figure 3

The changes in corneal endothelial cell counts in the groups during the follow-up period. There is no significant difference between two groups at all the time points.

Table 1

Comparison of baseline characteristics and final surgical outcome between trabeculectomy group and valve implantation group

Values are presented as mean ± SD unless otherwise indicated.

^*Independent t-test; ^†Fisher's exact test.

Table 2

Comparison of visual acuity between trabeculectomy and Ahmed valve implantation group at 12 month

Values are presented as mean ± SD.

^*Wilcoxon's rank sum test; ^†Wilcoxon's signed rank test; ^‡Paired t-test.

Table 3

Comparison of intraocular pressure between trabeculectomy and Ahmed valve implantation group at 12 month

Values are presented as mean ± SD.

^*Independent t-test; ^†Paired t-test.

Table 4

Comparison of corneal endothelial cell counts between trabeculectomy and Ahmed valve implantation group at 12 month

Values are presented as mean ± SD.

CEC = corneal endothelial cell count.

^*Independent t-test; ^†Paired t-test.

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