Eyeworld

Dr. Ahmed's colleague, Nir Shoham, M.D., will present a paper at the ASCRS•ASOA Symposium & Congress in San Diego that com- pares cataract extraction with the two drainage devices. "This retrospective, single sur- geon study of 66 eyes compared outcomes of combined phacoemulsi- fication with either Ahmed Glau- coma Valve (N=41) or Baerveldt Glaucoma Device (N=25)," accord- ing to the abstract. "Surgical success was defined as reduction in intraoc- ular pressure (IOP) >20%, an ab- solute 5 mm Hg ≤ IOP ≤ 18 mm Hg, with or without glaucoma medica- tions, no loss of light perception, no vision threatening complications and without further glaucoma sur- gery." The mean IOP and glaucoma medications after 1 year were com- parable between the two groups, al- though the phaco/Baerveldt group had a significantly higher IOP than the phaco/Ahmed group at 1 day (p<0.001) and 1 week (p<0.001) and a higher use of glaucoma medication classes at 1 week (p<0.001) and 1 month (p<0.001). Survival rates after 1 year were 80.5% with the Ahmed and 80% with the Baerveldt (p=0.839). There was no difference in complication rates (p=0.699) or improved visual acuity, maintained visual acuity, and loss of visual acuity between the two groups. There also was no significant difference in the intraocular pressure control, success rate, visual out- comes, and complication rates be- tween the phaco/Ahmed and the phaco/Baerveldt groups at 1 year after surgery. However, the phaco/ Baerveldt group required a greater number of post-op interventions (p=0.022). In response to the rising use in tube shunts, the Trabeculectomy Versus Tube study was conducted to compare complications and out- comes between patients. Patients who had previously undergone failed trabeculectomy or cataract surgery and required surgery for IOP control were randomized to undergo either trabeculectomy with mito- mycin-C or implantation of a non- restrictive Baerveldt implant. The 5-year study enrolled patients from 1999 to 2003. It included 212 pa- tients between ages 18 and 85 who had an IOP between 18 mm Hg and 40 mm Hg, and who had previous trabeculectomy, cataract explanta- tion with IOL implantation, or both. After 1 year, non-valved tube shunt surgery was found to be more likely to maintain IOP control and avoid persistent hypotony or reoperation for glaucoma than trabeculectomy with MMC. C E R T I F I E D O P H T H A L M I C E X E C U T I V E www.ASOA.org Leaders in Managing the Business of Ophthalmology O P H T H A L M I C E R T I F I E D T I F I E D E O P H T H A L M I ON M Sanders M. B TGO anders M. B "T h C e l w o n k c i ti c a ra p a c i d e m d r a u t o a h t t t th c a e f e fa h r u s s d a e ! i ti r e E c E ce O CO y o sy o u n a b u o r e t e to r g dg e y i gy i o l o m l a h th h p . O e c h y c i h r w r wh o h f h fo c n a ra l b a s r i r is o to a ra tr s is n in m d e h s t s th a e h h e s s m e r y gy o l o m l a h th h p y o d e s u c o y f y fo ry f e s a v s a ve y i y is a v o e t e to ve t a u h o h y h yo e w t o n k s u e b h th s m e r u s s a e d ! n o co c i ti c a ra p e h f t f th s o cs o ! i c e p e s e sp h w t w th O r C r CO e . H e d i s s ss s e n in s e s w e i e is w h t s a h e t e th s m p sp l a l e a l d n a y h ly h tl n e s rs e , p l, p a i c n a n ! e— c s l a l e s w d a l e ! n o i ti a n g ig s e E d O a d c n d a e d n u o l r l e g a n in n n u f r s o ts o c e p d n , a g, a n i di o , c l, c e n n o s n a g a d h m c u Sign your sta ophthalmic pr the fastest The A m mer . " e re o our sta! up for a fr up for a free trial memb thalmic practice sta!. !. est, most reliable, and accur merican Society of Oph h m thalmic A ee trial membership! curate resource for thalmic Administrators— susan@asoa.or or email Call Susan a Sign your sta . susan@asoa.or susan@asoa.org all Susan at 703-591-2220 our sta! up for a fr up for a free trial memb g ee trial membership! www.ASOA.org Placement of the EX-PRESS Glaucoma Filtration Device Source: Alcon continued on page 98 March 2011 COMBINED SURGERY 088-104 Feature_EW March 2011-DL_Layout 1 2/27/11 5:38 PM Page 97

• Cover