# Viscotrabeculotomy with anterior chamber irrigation versus Ahmed glaucoma valve implantation for silicone oil glaucoma in the pseudophakic eye

## TL;DR

This study compares two surgical treatments for glaucoma after silicone oil removal, finding that viscotrabeculotomy with irrigation is more effective and has fewer complications.

## Contribution

The study provides a direct comparison of two surgical techniques for post-silicone oil glaucoma in pseudophakic eyes.

## Key findings

- Viscotrabeculotomy with irrigation achieved a greater intraocular pressure reduction than Ahmed valve implantation.
- Viscotrabeculotomy had a higher success rate (72.73%) compared to Ahmed valve implantation (61.9%).
- Both procedures significantly reduced intraocular pressure at all follow-up time points.

## Abstract

To compare viscotrabeculotomy with anterior chamber irrigation to Ahmed
glaucoma valve implantation for secondary glaucoma following silicone oil
removal.

A prospective study was conducted on 43 vitrectomized pseudophakic eyes with
persistent glaucoma after silicone oil removal. Patients were randomized to
either viscotrabeculotomy with anterior chamber irrigation or Ahmed glaucoma
valve implantation. All patients were examined on day 1, week 1, and months
1, 3, 6, 9, 12, 18, and 24 postoperatively. Postoperative complications were
noted. Success was defined as an intraocular pressure between 6 and 20 mmHg
and with an intraocular pressure reduction of >30% compared with the
preoperative intraocular pressure.

There were 22 eyes in the viscotrabeculotomy with anterior chamber irrigation
and 21 eyes in the Ahmed glaucoma valve implantation group. The mean
preoperative and postoperative intraocular pressure in the
viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve
implantation groups were 35.5 ± 2.6 mmHg and 35.5 ± 2.4 mmHg
and 16.9 ± 0.7 mmHg and 17.9 ± 0.9 mmHg respectively
(p˂0.0001). There was a statistically significant intraocular pressure
reduction at all follow-up time points compared to preoperative values
(p˂0.0001) in both groups. The unqualified success rate in the
viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve
implantation groups were 72.73% and 61.9%, respectively. A minimal
self-limited hyphema was the most common complication.

Both viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma
valve implantation are effective in lowering the intraocular pressure in
glaucoma after silicone oil removal with viscotrabeculotomy with anterior
chamber irrigation providing greater reduction, higher success rates, and
minimal complications.