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مقاله
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Abstract
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Title:
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Ahmed Glaucoma Valve Implantation: Graft-Free Short Tunnel Small Flap versus Scleral Patch Graft After 1 Year Follow-up: a Randomised Clinical Trial
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Author(s):
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Mohammad Pakravan, MD,1 Mohammadmehdi Hatami, MD,2 Hamed Esfandiari, MD,3 Shahin Yazdani, MD,4Azadeh doozandeh, MD 2, Azadeh Samaeili MD,2 bahareh kheiri, MS2 Ian Conner, MD,PhD3
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Presentation Type:
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Oral
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Subject:
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Glaucoma
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Others:
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Presenting Author:
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Name:
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Azadeh Samaeili
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Affiliation :(optional)
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E mail:
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as100973@yahoo.com
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Phone:
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Mobile:
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09173159125
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Purpose:
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To compare the efficacy and safety of graft-free short tunnel small flap (STSF) technique with that of scleral patch graft (SPG) in Ahmed glaucoma valve (AGV) implantation.
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Methods:
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Patients were enrolled and assigned randomly to STSF or SPG.
Main Outcome Measures: tube exposure, Intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), surgical complications, and success rate ( defined as intraocular pressure (IOP) > 5 mmHg, ≤ 21 mmHg, and IOP reduction ≥ 20% from baseline at two consecutive visits after three months, no reoperation for glaucoma).
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Results:
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only one case in SPG developed tube exposure at 1-year follow-up. The cumulative probability of success during the first year of follow-up was 70% in the STSF and 65% in SPG (P= 0.36). IOP decreased significantly from 29.6 ± 8.6 mmHg at baseline to 16.4 ± 3.6 mmHg at the final follow-up in STSF (p= 0.001). The corresponding numbers for SPG were 30.9 ± 11.2 and 15.8 ± 4.7, respectively (p= 0.001). The final IOP was comparable between both groups (p= 0.65). Mean ± standard deviation of the number of glaucoma medications was 1.8 ± 0.9 in STSF and 1.6 ± 0.9 in SPG at final follow-up (P =0.32). Postoperative complications developed in 8 patients (19%) in STSF and 9 patients (23%) in SPG (P= 0.81).
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Conclusion:
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STSF and SPG techniques had comparable complication rate at one-year follow-up. Both techniques were comparable in terms of success rate, postoperative IOP, and glaucoma medications.
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Attachment:
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