Glaucoma Drainage Device (GDD) Implantation Following Ultrasound Cycloplasty (UCP) in Aphakic Glaucoma

Abstract

Purpose: A case of an aphakic glaucoma treated with two ultrasound circular cyclocoagulation procedures and posterior implantation of Ahmed valve device is presented.

Patients and Methods: Forty-year-old female with aphakic glaucoma in both eyes and elevated intraocular pressure in her single functioning right eye. Since this case involved a low vision eye and special anatomical features, it was decided to perform localized Ultrasound Circular Cyclo-Coagulation (UC3®)

Results: At 2 months it was necessary to repeat the procedure with UC3. At 6 months it was decided to implant an Ahmed valve device due to poor intraocular pressure control. The scleral tunnel was created 3 mm away from the corneoscleral junction and in between two scleral thinning marks, so as to minimize the risk of complications. At 3 years of follow-up, visual acuity remains stable and IOP is 14 mmHg.

Conclusions: UC3 can be indicated for eyes that have not undergone surgery and where, due to their anatomical and functional characteristics, it is advisable to use a fast and safe technique that ensures a prompt recovery. Several consecutive ultrasound cycloablation procedures do not preclude the possibility of a subsequent Ahmed-valve implantation, as long as the previously-treated scleral areas are avoided.