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DIFFERENT SURGICAL MODALITIES FOR MANAGEMENT OF PERSISTENT GLAUCOMA AFTER SILICONE OIL REMOVAL IN VITRECTOMIZED EYES: One Year Comparative Study

Purpose: Aim of this study was to compare outcome of four different surgical modalities for management of persistent glaucoma after silicone oil removal in vitrectomized eyes. Methods: This is a prospective comparative study, carried out on a cohort of 41 eyes (41 patients). Patients were randomly allocated to Group A (trabeculectomy), Group B (deep sclerectomy), Group C (Ahmed valve), or Group D (Ex-Press Minishunt). Postoperatively, all patients were followed regularly at 1 day, 1 week, 1, 3, and 6 months, and 1 year for intraocular pressure evaluation. Results: Postoperatively, there was significant drop in intraocular pressure in each group, and significant difference between the four groups regarding drop and percentage drop in intraocular pressure, with Group C showing the highest mean percentage drop in intraocular pressure, whereas Group B with the least. Success rate was 100% with Ex-Press minishunt, 80% with Ahmed valve, and 50% for each of trabeculectomy and deep sclerectomy. Hypotony occurred in 50% with Ahmed valve and 40% with trabeculectomy, whereas glaucoma occurred in 50% with deep sclerectomy and 30% with trabeculectomy. Conclusion: For controlling persistent glaucoma after silicone oil removal in our work, Ex-Press minishunt had the highest complete success rate with no postoperative complications.