Effect of Sub-Tenon's Triamcinolone on Hypertensive Phase and Clinical Outcomes Following Ahmed Glaucoma Valve Implantation in Neovascular Glaucoma Patients

球后注射曲安奈德对新生血管性青光眼患者植入Ahmed青光眼引流阀后高眼压期及临床结局的影响

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Abstract

PURPOSE: To evaluate the effect of sub-Tenon's triamcinolone acetonide (TA) on the hypertensive phase (HP) and postoperative outcomes in patients with neovascular glaucoma (NVG) after Ahmed glaucoma valve (AGV) surgery. METHODS: We conducted a retrospective review of 112 NVG patients (58 TA, 54 non-TA) who underwent AGV implantation with a 6-month follow-up. HP was defined as intraocular pressure (IOP) > 21 mm Hg within the first 3 months. Primary outcomes included IOP and HP occurrence. Secondary outcomes included complications, number of glaucoma drops, surgical failure, and visual acuity (VA). RESULTS: Non-TA patients were significantly more likely to develop HP (70 vs 50%, p = 0.03). Mean IOP (18.34 ± 7.96 vs 17.75 ± 6.16 mm Hg, p = 0.75), VA (1.46 ± 0.96 vs 1.32 ± 0.94 logMAR, p = 0.56), surgical failure (63 vs 48%, p = 0.13), rates of complication (9.3 vs 5.2%, p = 0.48), and number of glaucoma eye drops (2.59 ± 1.38 vs 2.18 ± 1.63, p = 0.29) were similar at 6 months. Compared to baseline, significant IOP reductions were observed in the TA group at month 1 (-24.62 ± 16.60 vs -18.43 ± 14.39 mm Hg, p = 0.05) and month 3 (-25.65 ± 14.05 vs -19.05 ± 13.14 mm Hg, p = 0.03). CONCLUSION: Sub-Tenon's TA reduces the risk of HP and short-term IOP spikes in NVG patients undergoing AGV implantation but does not improve long-term IOP regulation, visual outcomes, or surgical success. CLINICAL SIGNIFICANCE: Reducing HP may help prevent early postoperative complications, improving short-term management of NVG patients receiving AGV implants. HOW TO CITE THIS ARTICLE: Hong AT, Kishi SH, Humayun L, et al. Effect of Sub-Tenon's Triamcinolone on Hypertensive Phase and Clinical Outcomes Following Ahmed Glaucoma Valve Implantation in Neovascular Glaucoma Patients. J Curr Glaucoma Pract 2025;19(3):129-135.

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